Akiyama Kosuke, Karaki Masayuki, Hosikawa Hiroshi, Mori Nozomu
Department of Otolaryngology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Auris Nasus Larynx. 2013 Apr;40(2):239-42. doi: 10.1016/j.anl.2012.02.006. Epub 2012 Jun 2.
Adenoid cystic carcinoma (ACC) is a malignant tumor commonly occurring in the major salivary glands. ACC of the nasal septum is exceeding rare.
The case of a 42-year-old woman with ACC of the nasal septum is presented. Her chief complaint was nasal obstruction and dysosmia for two month. CT and MRI demonstrated a massive mass occupying the nasal septum infiltrating the palate, vomeronasal, anterior skull base, and dura mater. Combined anterior cranial surgery, endoscopic intranasal surgery, and transpalatal surgery were selected due to the size and location of the tumor. A negative surgical margin was achieved without cosmetic deformity or functional disorder.
She had postoperative radiotherapy with no recurrence or distant metastasis during the follow-up period.
The tumor location and the perineural spread pattern should be considered to determine the treatment plan for septum ACC. Post operative radiation is now generally recommended. ACC has a high incidence of local recurrence and distant metastasis rate; therefore, long-term follow-up is necessary.
腺样囊性癌（ACC）是一种常见于大唾液腺的恶性肿瘤。鼻中隔腺样囊性癌极为罕见。
本文报告了一例42岁患有鼻中隔腺样囊性癌的女性病例。她的主要症状是鼻塞和嗅觉障碍两个月。CT和MRI显示一个巨大肿块占据鼻中隔，浸润腭部、犁鼻器、前颅底和硬脑膜。由于肿瘤的大小和位置，选择了联合前颅手术、鼻内镜手术和经腭手术。手术切缘阴性，无美容畸形或功能障碍。
她接受了术后放疗，随访期间无复发或远处转移。
确定鼻中隔ACC的治疗方案时应考虑肿瘤位置和神经周围扩散模式。目前一般建议术后放疗。ACC局部复发率和远处转移率较高；因此，需要长期随访。
