Ulubas Bahar, Ozcan Cengiz, Polat Ayse
Department of Chest Disease, Faculty of Medicine, Mersin University, Mersin, Turkey.
J Craniofac Surg. 2010 May;21(3):781-3. doi: 10.1097/SCS.0b013e3181d7f186.
Among all parotid gland tumors, small cell cancer is rare, seen in only 1.7%. Tumoral findings in the parotid gland may sometimes be caused by metastasis, and diagnosis in these patients may be made at this metastatic focus. A 59-year-old male patient presented with a 3 x 4-cm painless mass in front of the mandibula. A malignant epithelial tumor was diagnosed after the histopathologic examination of the fine-needle aspiration biopsy specimen. The patient did not give consent for urgent parotidectomy. One month later, he presented again, indicating the growth of the mass. On the examination, it was noted that the mass had enlarged and become ulcerated. Incisional biopsy was applied for this lesion. The biopsy material revealed small cell cancer. Scanning of other systems was performed with the suspicion of a metastatic tumor, which revealed a mass with an undefined border separating it from the right main bronchus and numerous hypodense focuses in the patient's liver on thoracoabdominal computed tomography. In addition to the multiple metastatic focuses in the cranium, there were multiple bone metastases in the vertebra and the proximal parts of the bilateral femurs on bone scintigraphy. Due to bronchoscopy, an endobronchial lesion was seen on the right upper lobe bronchus, the biopsy material obtained from this area was diagnosed as small cell lung cancer. This case was presented because of its rarity as a first diagnostic site. Parotid gland small cell cancer metastasis from the lung is rare, and if a careful examination is not performed, primary focus may be overlooked, negatively affecting the lifetime survival rate and the prognosis of the patient.
在所有腮腺肿瘤中，小细胞癌很罕见，仅占1.7%。腮腺肿瘤的表现有时可能是由转移引起的，这些患者的诊断可能在转移灶处做出。一名59岁男性患者在下颌骨前方出现一个3×4厘米的无痛性肿块。细针穿刺活检标本的组织病理学检查后诊断为恶性上皮性肿瘤。患者不同意紧急进行腮腺切除术。一个月后，他再次就诊，表明肿块增大。检查时发现肿块增大并已溃疡。对该病变进行了切开活检。活检材料显示为小细胞癌。由于怀疑有转移性肿瘤，对其他系统进行了扫描，胸部腹部计算机断层扫描显示右主支气管旁有一个边界不清的肿块，患者肝脏内有多个低密度灶。骨闪烁显像显示除颅骨有多个转移灶外，椎骨和双侧股骨近端还有多个骨转移。由于支气管镜检查，在右上叶支气管可见一个支气管内病变，从该区域获取的活检材料诊断为小细胞肺癌。该病例因其作为首个诊断部位的罕见性而被呈现。肺转移至腮腺的小细胞癌很罕见，如果不进行仔细检查，可能会忽略原发灶，对患者的生存期和预后产生负面影响。
