下颌下腺肿瘤的术前评估与手术规划
Preoperative evaluation and surgical planning of submandibular gland tumors.
作者信息
Atula Timo, Panigrahi Juha, Tarkkanen Jussi, Mäkitie Antti, Aro Katri
机构信息
Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Department of Pathology, HUSLAB, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
出版信息
Head Neck. 2017 Jun;39(6):1071-1077. doi: 10.1002/hed.24691. Epub 2017 Mar 28.
BACKGROUND
Roughly half of submandibular gland neoplasms are malignant. Because preoperative information on the nature of these tumors remains limited, both preoperative evaluation and assessment of the extent of primary surgery warrant guidelines that are more accurate.
METHODS
We evaluated the preoperative examinations and management of all submandibular gland neoplasms treated surgically at the Helsinki University Hospital between 2000 and 2010.
RESULTS
Of the 83 tumors, 58 (70%) were benign and 25 (30%) were malignant. Of the benign tumors, 54 (93%) were pleomorphic adenomas. The cytology in 8 patients (10%) was class IV or V, and in 12 patients was class III; the tumors in 9 of these 12 patients turned out to be malignant. Of all malignancies, 10 (40%) required additional more extensive surgery.
CONCLUSION
Ultrasound-guided fine-needle aspiration cytology (FNAC) proved useful, with limitations, in preoperative examination. Surgeons should always obtain wide margins whenever possible, even when clinical means or cytology indicates no malignancy. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1071-1077, 2017.
背景
大约一半的下颌下腺肿瘤是恶性的。由于这些肿瘤性质的术前信息仍然有限，术前评估和原发性手术范围的评估都需要更准确的指导方针。
方法
我们评估了2000年至2010年期间在赫尔辛基大学医院接受手术治疗的所有下颌下腺肿瘤的术前检查和处理情况。
结果
83例肿瘤中，58例（70%）为良性，25例（30%）为恶性。良性肿瘤中，54例（93%）为多形性腺瘤。8例患者（10%）的细胞学检查为IV级或V级，12例患者为III级；这12例患者中有9例的肿瘤最终被证实为恶性。在所有恶性肿瘤中，10例（40%）需要进行额外的更广泛手术。
结论
超声引导下细针穿刺细胞学检查（FNAC）在术前检查中证明是有用的，但有局限性。外科医生应尽可能始终获得足够宽的切缘，即使临床检查或细胞学检查未提示恶性。©2017威利期刊公司。《头颈》39: 1071 - 1077, 2017。
Zotero 插件