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目的探讨中耳耵聍腺肿瘤的临床病理特点、诊治方法及预后情况。方法回顾分析确诊为不同类型耵聍腺肿瘤3例患者的临床资料,加以总结。结果随访至2014年12月,其中1例中耳耵聍腺瘤患者术后6年,未见复发及转移;1例中耳耵聍腺癌患者经手术及放疗后(20 Gy)1年复发,再次手术及放疗,2年后出现面瘫怀疑肿瘤复发,因患者放弃治疗,未能明确,但随访6年仍存活;1例腺样囊腺癌患者行2次手术及P53治疗1年后发生颌下转移,再次手术及放疗,随访9个月后,影像学提示肿瘤复发并转移至颅内,未再治疗,至随访结束时仍存活。结论中耳耵聍腺肿瘤的早期诊断困难,易复发,其确诊有赖于临床特点、影像学和组织病理学检查,其治疗方式及预后与肿瘤类型相关,耵聍腺瘤以手术治疗为主,耵聍腺癌及腺样囊性癌应采用以手术治疗为主的综合治疗。
Objective To investigate the clinicopathological characteristics, diagnosis and treatment methods and prognosis of the middle ear Adenocarcinoma. Methods The clinical data of 3 patients with different types of Adenocarcinoma diagnosed by retrospective analysis were summarized and summarized. Results All patients were followed up until December 2014. One patient with middle ear Adenocarcinoma had no recurrence and metastasis at 6 years postoperatively. One patient with middle ear Astigmatism was relapsed after surgery and radiotherapy (20 Gy) , Again surgery and radiotherapy, facial paralysis 2 years later suspected tumor recurrence, because patients give up treatment, failed to be clear, but still alive after 6 years of follow-up; 1 case of adenoid cystadenocarcinoma patients underwent two operations and P53 occurred after 1 year Submandibular metastasis, reoperation and radiotherapy. After 9 months of follow-up, radiography showed that the tumor recurred and metastasized to the intracranial area without further treatment and survived till the end of follow-up. Conclusion The diagnosis of middle ear otolith adenoma is difficult and easy to be diagnosed. The diagnosis depends on the clinical features, imaging and histopathological examination. The treatment and prognosis are related to the tumor type.耵 聍 Adenocarcinoma and adenoid cystic carcinoma should be based on the comprehensive treatment of surgical treatment.