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患者女,55岁。以左颌下区无痛性巨大肿物30年入院于11—05—20,在30年前发现口底肿物。均匀增大,近一年来肿物增长迅速而来诊。检查:一般情况良好,左颌下区膨隆,前界在颌下正中线偏右1.5cm,后界在下颌角下面积约13cm×8.5cm,质地软,界不清,表面光滑,活动度尚好,表面无粘连,无压痛。肿物基底部深在,同侧舌下肉阜、舌下腺导管处粘膜隆起。颌下、颈部淋巴结未触及。治疗:局麻下手术切除左侧颌下腺及肿物,术中发现肿物位于颌下腺深面,与颌下腺粘连紧密,表面光滑,有完整包膜,内容物为淡黄色粘稠豆渣样物。吸出约100ml后肿物尚有鹅卵大。连同颌下腺一并完整剥出,术后血管一期愈合。病理检查:镜下见囊壁显示结缔组织,内壁为鳞状上皮,囊内为角化物。病理诊断:表皮样囊肿。
Female patient, 55 years old. In the left submandibular painless huge tumor was admitted to hospital for 30 years in the 11-05-20, 30 years ago, found the mouth tumor. Evenly increased, the rapid growth of the past year to visit the tumor. Check: generally good, the left submandibular swelling, the frontier in the submandibular median line 1.5cm to the right, the posterior under the mandibular angle in the area of about 13cm × 8.5cm, soft texture, unclear boundaries, smooth surface, good mobility , The surface no adhesion, no tenderness. Submandibular deep tumor in the ipsilateral sublingual tongue Fu Fu, subdural duct mucosal uplift. Submandibular and cervical lymph nodes not touched. Treatment: under local anesthesia surgery to remove the left submandibular gland and tumor, the tumor was found in the submandibular gland deep surface, and submandibular gland adhesions close, smooth surface, a complete envelope, the contents of light yellow sticky dregs samples. Suction of about 100ml after the tumor there are still large goose. Together with the submandibular glands complete stripping, postoperative vascular healed. Pathological examination: see the cyst wall to see the connective tissue microscope, the inner wall of squamous epithelium, cysts for the keratosis. Pathological diagnosis: epidermoid cyst.