Chow T L, Chan Tony T F, Choi C Y, Lam S H
Division of Head and Neck Surgery, Department of Surgery, United Christian Hospital, Kwun Tong, Kowloon, Hong Kong.
Hong Kong Med J. 2008 Feb;14(1):46-9.
To study clinical perspectives pertaining to chronic sclerosing sialadenitis, which is also known as Kuttner's tumour.
Retrospective medical chart review.
Regional hospital, Hong Kong.
From February 2005 to February 2007, nine cases with Kuttner's tumour were identified from our hospital electronic database.
They underwent submandibular sialadenectomy under either local (n=6) or general (n=3) anaesthesia.
The results of preoperative ultrasonography, fine-needle aspiration cytology, and intra-operative frozen section examination were correlated with the final diagnosis. Operative morbidity was also evaluated.
The mean age of the patients at diagnosis was 61 years; three were females. Three had bilateral submandibular swellings. Following preoperative ultrasonography in six of the patients, tumours were suspected in two, an enlarged lymph node in one, and diffuse enlargement was visualised in the other three. Six patients had preoperative fine-needle aspiration cytology; five yielded scanty acini with normal-looking ductal cells, variable degrees of infiltration by chronic inflammatory cells without granuloma admixing fibrosis. In the sixth patient, only bland-looking epithelial cells, indicative of ductal differentiation suspicious of neoplasm were noted. Intra-operative frozen section examination was conducted in three patients: chronic inflammation without evidence of carcinoma was visualised in each. Operations performed under local anaesthesia were well tolerated; only one patient endured a transient, marginal facial nerve palsy.
Kuttner's tumour is by no means rare. When supported by ultrasonography and fine-needle aspiration cytology, an accurate diagnosis can be made preoperatively and surgery can be reserved for symptomatic cases. Submandibular sialadenectomy is a safe and effective means of treating Kuttner's tumour, and can be accomplished under local anaesthesia.
研究与慢性硬化性涎腺炎（又称库特纳瘤）相关的临床观点。
回顾性病历审查。
香港地区医院。
2005年2月至2007年2月期间，从我院电子数据库中识别出9例库特纳瘤患者。
他们在局部麻醉（n = 6）或全身麻醉（n = 3）下接受了下颌下腺切除术。
术前超声检查、细针穿刺细胞学检查及术中冰冻切片检查结果与最终诊断结果进行相关性分析。同时评估手术并发症。
患者确诊时的平均年龄为61岁；3例为女性。3例有双侧下颌下肿胀。6例患者术前行超声检查，其中2例怀疑有肿瘤，1例为肿大淋巴结，另外3例可见弥漫性肿大。6例患者术前行细针穿刺细胞学检查；5例吸出少量腺泡，导管细胞外观正常，有不同程度的慢性炎症细胞浸润，无肉芽肿及纤维化。第6例患者仅见外观平淡的上皮细胞，提示导管分化，怀疑有肿瘤。3例患者进行了术中冰冻切片检查：每例均显示为慢性炎症，无癌变证据。局部麻醉下进行的手术耐受性良好；仅1例患者出现短暂的边缘性面神经麻痹。
库特纳瘤并不罕见。当超声检查和细针穿刺细胞学检查支持时，术前可作出准确诊断，手术可仅用于有症状的病例。下颌下腺切除术是治疗库特纳瘤的一种安全有效的方法，可在局部麻醉下完成。
