Iguchi Hiroyoshi, Uyama Taichi, Takayama Yasushi, Yamane Hideo
Department of Otolaryngology and Head & Neck Surgery, Osaka City University Graduate School of Medicine, Osaka.
Nihon Jibiinkoka Gakkai Kaiho. 2011 Feb;114(2):84-9. doi: 10.3950/jibiinkoka.114.84.
Congenital aplasia of the major salivary gland is a rare condition. We report on a case of bilateral aplasia of the submandibular glands associated with a left submandibular hemangioma. A 62-year-old woman came to our department complaining of a 3-year history of left submandibular swelling. She had no notable family or personal medical history. On physical examination of the head and neck region, a 30 mm, non-tender mass was palpated in the left submandibular area. On imaging examinations including ultrasonography and CT, lack of the right submandibular gland and a left submandibular mass with calcification were demonstrated. Fine needle aspiration cytology resulted in blood elements only. Functioning tissue could not be observed in the bilateral submandibular glands on technetium pertechnetate scintigraphy. We performed a left submandibular tumor extirpation. Intraoperatively, the left submandibular gland and duct were missing. On pathologic examination, the tumor was found to be a hemangioma. The parotid and sublingual glands were recognized bilaterally on postoperative MRI. Her postoperative condition was satisfactory. This condition may be due to the dysfunction of several factors, such as fibroblast growth factors, related to gland differentiation.
先天性大唾液腺发育不全是一种罕见的病症。我们报告一例双侧下颌下腺发育不全并伴有左侧下颌下血管瘤的病例。一名62岁女性因左侧下颌下肿胀3年前来我科就诊。她没有明显的家族病史或个人病史。对头颈部区域进行体格检查时,在左侧下颌下区可触及一个30毫米、无压痛的肿块。在包括超声和CT在内的影像学检查中,显示右侧下颌下腺缺如以及左侧下颌下有一个伴有钙化的肿块。细针穿刺细胞学检查仅见血液成分。在高锝酸盐闪烁扫描中,双侧下颌下腺均未观察到有功能的组织。我们进行了左侧下颌下肿瘤切除术。术中发现左侧下颌下腺及导管缺失。病理检查发现肿瘤为血管瘤。术后MRI显示双侧腮腺及舌下腺正常。她术后情况良好。这种情况可能是由于多种与腺体分化相关的因素(如成纤维细胞生长因子)功能异常所致。