慢性非典型首口综合征和腮腺原发性鳞状细胞癌。
Chronic atypical first bite syndrome and primary squamous cell carcinoma of the parotid.
机构信息
Department of Otolaryngology/Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
Orofacial Pain Clinic-Department of Endodontics, University of North Carolina School of Dentistry, Chapel Hill, North Carolina.
出版信息
Head Neck. 2018 Aug;40(8):E82-E86. doi: 10.1002/hed.25321. Epub 2018 Jun 21.
BACKGROUND
First bite syndrome is a well-recognized complication of parapharyngeal space surgery. There are no reported cases of protracted first bite syndrome and subsequent diagnosis of a primary squamous cell carcinoma (SCC) of the parotid.
METHODS
We present the case of a 73-year-old man with no surgical history and 9 years of first bite syndrome who was ultimately diagnosed with a primary SCC of the parotid. Diagnostic workup, including MRI and biopsy, along with oncologic treatment, were performed.
RESULTS
Surgical treatment confirmed malignancy and also resulted in complete resolution of the first bite syndrome.
CONCLUSION
First bite syndrome without prior surgery may warrant further diagnostic workup with imaging to evaluate for salivary gland pathology. When no radiographic mass lesion is detected but the patient displays protracted symptoms unresponsive to conservative therapy, one should maintain an index of suspicion for malignancy, especially in the presence of symptom escalation.
背景
第一口综合征是咽旁间隙手术的一种公认并发症。目前尚无报道称第一口综合征迁延不愈，并随后诊断为腮腺原发性鳞状细胞癌（SCC）。
方法
我们报告了 1 例 73 岁男性病例，无手术史，第一口综合征持续 9 年，最终诊断为腮腺原发性 SCC。进行了包括 MRI 和活检在内的诊断性检查，以及肿瘤治疗。
结果
手术治疗证实为恶性肿瘤，第一口综合征也完全缓解。
结论
无既往手术史的第一口综合征可能需要进一步影像学检查以评估唾液腺病变。如果没有发现影像学肿块，但患者的症状迁延不愈且对保守治疗无反应，即使没有放射状肿块，也应保持对恶性肿瘤的怀疑，特别是在症状加重的情况下。
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