Department of Radiology, Aerospace Center Hospital, Beijing, China.
Department of Pathology, Aerospace Center Hospital, Beijing, China.
Medicine (Baltimore). 2023 Mar 24;102(12):e33348. doi: 10.1097/MD.0000000000033348.
Salivary gland tumors account for approximately 3% of all tumors, most of which are benign, with pleomorphic adenomas being the most common, occurring mostly in middle-aged women, mostly originating from the major salivary glands and, to a lesser extent, from the minor salivary glands, with the tongue being a very rare site of occurrence. To date, case reports of pleomorphic adenoma at the root of the tongue are also rare.
A 56-year-old male patient with no obvious cause of foreign body sensation in the pharynx, sputum, no pain, no blood in the sputum, no dysphagia, and no difficulty in swallowing and breathing, which was significantly aggravated in the past 2 weeks, with difficulty in swallowing, breath-holding on lying down.
computed tomography and magnetic resonance imaging revealed a soft tissue mass at the root of the left tongue, which involved the tongue body in the forward direction. Electronic laryngopharyngoscopy showed a left-sided tongue root mass with a poorly smooth mucosa, covered with a mucous white pseudomembrane and a localized brownish-black crust without active bleeding. The final pathological findings showed a pleomorphic adenoma.
Postoperative symptomatic treatment was given, and the patient recovered well. Eight days after surgery, the patient was discharged from the hospital, and the pharyngeal pain basically subsided at the time of discharge, with no fever and no pharyngeal discomfort. Postoperative laryngoscopy showed smooth mucosa of the pharyngeal cavity, good pseudomembrane formation in the operated area, no active bleeding, no purulent secretions, and normal blood routine on recheck. The medical advice after discharge was firstly, full rest for 1 week, secondly, continue the oral anti-inflammatory treatment, 1 week after the operation need to review the outpatient clinic, finally, if there are any uncomfortable symptoms, seek medical attention in time.
At present, the patient has been followed up for half a year and has recovered well from the operation without any discomfort.
It is very rare to find a pleomorphic adenoma of the tongue, and it occurs mostly in middle-aged women. In clinical diagnosis, it is sometimes difficult to distinguish it from malignant tumor of the tongue.
唾液腺肿瘤约占所有肿瘤的 3%,其中大多数为良性,多形性腺瘤最为常见,多发生于中年女性,主要来源于大唾液腺,其次来源于小唾液腺,舌部为非常罕见的发生部位。迄今为止,舌根多形性腺瘤的病例报告也很少见。
一名 56 岁男性患者,无明显咽部异物感、咳痰、无疼痛、无痰中带血、无吞咽困难、无呼吸困难,近 2 周症状明显加重,吞咽困难,平卧时憋气。
计算机断层扫描和磁共振成像显示左舌根软组织肿块,向舌体前方延伸。电子喉镜显示左舌根肿块,黏膜不平滑,覆有白色假膜,局部有棕黑色痂皮,无活动性出血。最终的病理结果显示为多形性腺瘤。
术后给予对症治疗,患者恢复良好。术后 8 天,患者出院,出院时咽部疼痛基本缓解,无发热,咽部无不适。术后喉镜检查见咽腔黏膜光滑,术区假膜形成良好,无活动性出血,无脓性分泌物,复查血常规正常。出院医嘱:一、全休 1 周;二、继续口服抗炎治疗;术后 1 周需门诊复查;三、如有任何不适症状,及时就医。
目前,患者已随访半年,手术恢复良好,无任何不适。
舌部多形性腺瘤非常罕见,多见于中年女性。在临床诊断中,有时很难将其与舌部恶性肿瘤相鉴别。