Hauer Lukas, Gencur Jiri, Posta Petr, Kasl Zdenek, Rusnak Stepan, Skalova Alena, Chalupova Miroslava, Liska Jan, Merglova Vlasta
Department of Dentistry, University Hospital and Faculty of Medicine in Pilsen, Charles University, Alej Svobody 80, 304 60 Pilsen, Czech Republic.
Clinic of Ophthalmology, University Hospital and Faculty of Medicine in Pilsen, Charles University, Alej Svobody 80, 304 60 Pilsen, Czech Republic.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2022 Mar;166(1):117-125. doi: 10.5507/bp.2020.051. Epub 2020 Nov 26.
An ocular adnexal apocrine adenocarcinoma (OAAA) is an extremely rare, but potentially aggressive and life-threatening tumor with ill-defined management based only on recommendations from a limited number of reported cases. The development of cervical lymphocele following neck dissection is a very rare complication, but one with well established methods for prevention and treatment. Here we describe a previously unreported case of salvage surgery including neck dissection for OAAA in addition to an emergence of cervical lymphocele. A literature review of current knowledge on both pathological conditions is included.
A 58-year-old man suffering from OAAA, previously treated with multiple eye-sparing excisions and adjuvant proton therapy, underwent salvage surgery for locoregional recurrence of the tumor. A partial orbitectomy with orbital exenteration, primary reconstruction and left-sided neck dissection was performed. The procedure was complicated by a cervical lymphocele resolved after the surgical therapy. The patient remained disease-free during the one-year follow-up.
OAAA is a locally aggressive tumor with potential to local or distant metastatic spread. Whole-body staging, regular clinico-radiological follow-up and stage-dependent therapy with surgery as the first-choice treatment is required. A cervical lymphocele as a complication of especially left-sided neck dissection is managed with a conservative or surgical therapy according to the level of lymph leakage, extent and localization of lesions, presence of local or systemic disorders and the period from primary surgery.
眼附属器大汗腺癌（OAAA）是一种极为罕见但具有潜在侵袭性且危及生命的肿瘤，仅基于少数报道病例的建议，其治疗方法尚不明确。颈部清扫术后发生颈淋巴囊肿是一种非常罕见的并发症，但有成熟的预防和治疗方法。在此，我们描述一例此前未报道的病例，该病例除出现颈淋巴囊肿外，还对OAAA进行了挽救性手术，包括颈部清扫。本文还对这两种病理情况的现有知识进行了文献综述。
一名58岁患有OAAA的男性，此前接受过多次保留眼球的切除术及辅助质子治疗，因肿瘤局部区域复发接受了挽救性手术。进行了部分眶内容剜除术、一期重建及左侧颈部清扫。该手术因术后出现颈淋巴囊肿而变得复杂，但经手术治疗后囊肿得以消退。患者在一年的随访期间无疾病复发。
OAAA是一种具有局部侵袭性的肿瘤，有局部或远处转移扩散的可能。需要进行全身分期、定期临床影像学随访，并根据分期进行以手术为首选治疗方法的治疗。作为特别是左侧颈部清扫术并发症的颈淋巴囊肿，应根据淋巴漏的程度、病变的范围和定位、局部或全身疾病的存在情况以及初次手术的时间，采用保守或手术治疗。
