Jeong Han-Sin, Son Young-Ik, Baek Chung-Hwan
Department of Otolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Am J Otolaryngol. 2006 Jan-Feb;27(1):5-8. doi: 10.1016/j.amjoto.2005.05.010.
The rarity of malignant tumors in the periorbital area makes it difficult to assess the patterns of lymphatic spread and to determine the optimal extent of treatment. The objective of this study was to analyze the patterns of lymphatic metastasis in malignant tumors arising from the periorbital area according to the primary site and to assess the optimal extent of surgical treatment for these tumors.
We retrospectively reviewed the medical records of 8 patients with malignant tumors in the periorbital area from January 1997 to June 2002. The mean duration of follow-up was 27.5 months. Five primary tumors were located in the medial half of the periorbital area, 2 tumors in both medial and lateral halves, and 1 tumor in the lateral half. The pathological diagnoses were 3 squamous cell carcinomas, 2 adenoid cystic carcinomas, 2 sebaceous carcinomas, and 1 basal cell carcinoma.
The lymphatic metastasis was observed in 4 of 8 patients who had a relatively large (> or =4 cm) primary tumor or poorly differentiated tumor. Four of 7 tumors involving the medial half of the periorbital area exhibited lymphatic spread to the periparotid lymph node and level II cervical lymph node groups.
The results of this study suggest that more aggressive management of the parotid area is necessary in malignant tumors arising from the periorbital area, even in the medial half of the periorbital area.
眶周区域恶性肿瘤较为罕见，这使得评估其淋巴转移模式及确定最佳治疗范围变得困难。本研究的目的是根据原发部位分析眶周区域恶性肿瘤的淋巴转移模式，并评估这些肿瘤手术治疗的最佳范围。
我们回顾性分析了1997年1月至2002年6月期间8例眶周区域恶性肿瘤患者的病历。平均随访时间为27.5个月。5例原发肿瘤位于眶周区域的内侧半侧，2例位于内侧和外侧半侧，1例位于外侧半侧。病理诊断为3例鳞状细胞癌、2例腺样囊性癌、2例皮脂腺癌和1例基底细胞癌。
8例患者中，4例原发肿瘤相对较大（≥4 cm）或分化较差的患者出现了淋巴转移。7例累及眶周区域内侧半侧的肿瘤中，4例表现出向腮腺周围淋巴结和Ⅱ区颈部淋巴结组的淋巴转移。
本研究结果表明，对于眶周区域发生的恶性肿瘤，即使是在眶周区域的内侧半侧，也需要对腮腺区域进行更积极的处理。
