山东大学耳鼻喉眼学报 ›› 2015, Vol. 29 ›› Issue (6): 8-12.doi: 10.6040/j.issn.1673-3770.0.2015.227

• 论著 • 上一篇    下一篇

中耳耵聍腺肿瘤3例并文献复习

吕丹1, 杨慧1, 尹锐2, 辜德英1, 郑义涛1   

  1. 1. 四川大学华西医院, 耳鼻咽喉头颈外科, 四川 成都 610041;
    2. 四川大学华西医院, 病理科, 四川 成都 610041
  • 收稿日期:2015-06-09 出版日期:2015-12-16 发布日期:2015-12-16
  • 通讯作者: 杨慧. E-mail:yh8806@163.com E-mail:yh8806@163.com
  • 作者简介:吕丹. E-mail:dashijie001@163.com
  • 基金资助:
    四川省科技厅支撑计划(2012FZ0014);成都市科技局科技惠民项目(0040205301A66)

The middle ear cerumen gland tumor of three cases and review of the literature

LÜ Dan1, YANG Hui1, YIN Rui2, GU Deying1, ZHENG Yitao1   

  1. 1. Department of Otolaryngology & Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China;
    2. Department of Pathology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
  • Received:2015-06-09 Online:2015-12-16 Published:2015-12-16

摘要: 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.

关键词: 中耳, 病理, 耵聍腺肿瘤, 腺样囊腺癌

Abstract: Objective To analyze the clinical and pathological feature, therapy and outcome of ceruminous gland tumor of the middle ear. Methods We reviewed the clinical findings of three cases with ceruminous gland tumor from November 2006 to October 2014. Results Follow up to December 2014, one patient was diagnosed ceruminal adenoma who have been followed up for more than 6 years, there were no recurrence. One case with ceruminous carcinoma who received surgery and radiotherapy was relapsed during after followed up one year, and he accepted surgery and radiotherapy, after about 2 years the patient with suspected relapse.One case was diagnosed adenoid cystic carcinoma, and she received treatment with P53. However, she was relapsed after 1 year, and she received surgery and postoperative radiotherapy. Follow up for more than 9 months, considered that the tumor recurrence and metastasis to the brain. Conclusion The early diagnosis of ceruminous gland tumor is difficult, and easy to relapse, the diagnosis relies on clinical characteristic, imaging studies and histopathologic appearance.The treatment method and prognosis depends on tumor types, ceruminous adenoma is mainly treated with surgery, ceruminal adenocarcinoma and adenoid cystic carcinoma should adopt comprehensive treatment based on surgery.

Key words: Pathology, Middle ear, Adenoid cystic carcinoma, Ceruminous gland tumor

中图分类号: 

  • R739.61
[1] Derlacki E L, Barney P L. Adenomatous tumours of the middle ear and mastoid[J]. Laryngoscope, 1976, 86(8):1123-1135.
[2] 陈杰,王健,邓毅.耵聍腺肿瘤临床分析(附18例分析)[J].山东医大基础医学院学报,2001,15(1):9-10. CHEN Jie, WANG Jian, DENG Yi. Clinical analysis of ceruminal gland neoplasm:with a report of 18 cases[J]. J Preclin Med Coll Shandong Med Univ, 2001, 15(1):9-10.
[3] Pedersen C B, Sgaard H. Ceruminoma in the middle ear behind an intact tympanic membrane[J]. Ugeskr Laeger, 1984, 146(7):517-518.
[4] Wetli C V, Pardp V, Millard M, et al. Tumors of ceruminous glands[J]. Cancer, 1972, 29(5):1169-1178.
[5] Orendorz-Fraczkowska K, Jaworska M, Gawron W, et al. Middle-ear ceruminous adenoma as a rare cause of hearing loss and vertigo: case reports[J]. Auris Nasus Larynx, 2005, 32(4):393-397.
[6] Devaney K O, Ferlito A, Rinaldo A. Epithelial tumors of the middle ear-are middle ear carcinoids really distinct from middle ear adenomas?[J]. Acta Otolaryngol, 2003, 123(6):678-682.
[7] Schenk P, Handisurya A, Steurer M. Ultrastructural morphology of a middle ear ceruminoma[J]. ORL J Otorhinolaryngol Relat Spec, 2002, 64(5):358-363.
[8] 朱杭军,张建东,孙秀兰.原发于中耳耵聍腺瘤1例报道(附文献复习)[J].解剖与临床,2011,16(4):313-314. ZHU Hangjun, ZHANG Jiandong, SUN Xiulan. Primary ceruminoma of middle ear: a case report and review of literatures[J]. Anat Clin, 2011, 16(4):313-314.
[9] 李德民,蒋立新.中耳耵聍腺瘤1例报告[J].耳鼻咽喉-头颈外科,2002,9(2):128. LI Demin, JIANG Lixin. A case report of middle ear ceruminal adenoma[J]. Chin Arch Otolaryngol Head Neck Surg, 2002, 9(2):128.
[10] 杨文华.外耳道癌及中耳癌手术与术后放疗疗效分析[J].肿瘤研究与临床,2000,12(4):130-131. YANG Wenhua. Analysis of postoperative radiotherapy and postsurgery for carcinoma of external auditory canal and middle ear carcinoma[J]. Cancer Res Clin, 2000,12(4):130-131.
[11] 常松年,凌敏,孙勤,等.耵聍腺癌双肺和颞骨转移一例[J].肺癌杂志,1998,1(1):61. CHANG Songnian, LING Min, SUN Qin, et al. A case of adenocarcinoma metastasis to lung and temporal bone[J]. Chin J Lung Cancer, 1998, 1(1):61.
[12] 杨宁,蒋立新.鼓室成形术后发生腺样囊性癌一例[J].中华耳鼻咽喉头颈外科杂志,2009,44(3):259-260. YANG Ning, JIANG Lixin. A case report of adenoid cystic carcinoma after tympanoplasty[J]. Chin J Otorhinolaryngol Head Neck Surg, 2009, 44(3):259-260.
[13] Conlin P A, Mira J L, Graham S C, et al. Ceruminous gland adenoid cystic carcinoma with contralateral metastasis to the brain[J]. Arch Pathol Lab Med, 2002, 126(1):87-89.
[14] Bradley P J. Adenoid cystic carcinoma of the head and neck: a review[J]. Curr Opin Otolaryngol Head Neck Surg, 2004, 12(2):127-132.
[15] 张明山,张宏伟,夏雷,等.侵袭颞骨的腺样囊性癌一例[J].中华脑科疾病与康复杂志,2011,10(1):73-75. ZHANG Mingshan, ZHANG Hongwei, XIA Lei, et al. A case report of adenoid cystic carcinoma of the temporal bone invasion[J]. Chin J Brain Dis Rehabil(Electronic Edition), 2011,10(1):73-75.
[16] 刘梦雨,马林,杨波,等.头颈部腺样囊性癌的CT和MRI诊断[J].实用放射学杂志,2008,24(6):741-744. LIU Mengyu, MA Lin, YANG Bo, et al. CT and MRI diagnosis of adenoid cystic carcinoma of the head and neck[J]. J Pract Radiol, 2008, 24(6):741-744.
[17] 杜强,王正敏.外耳道腺样囊性癌6例[J].临床耳鼻咽喉杂志,2006,20(4):158-159. DU Qiang, WANG Zhengmin. Six cases of adenoid cystic carsinoma in external auditory canal[J]. J Clin Otorhinolaryngol, 2006, 20(4):158-159.
[18] Karja V J, Syrjanen K J, Kurvinen A K, et al. Expression and mutations of P53 in salivary gland tumours[J]. J Oral Pathol Med, 1997, 26(5):217-223.
[19] 闫炳智,王洁,张波,等.P53对涎腺腺样囊性癌细胞端粒酶活性的抑制作用[J].基础医学与临床,2005,25(3):204-208. YAN Bingzhi, WANG Jie, ZHANG Bo, et al. Inhibition of telomerase activity in salivary adenoid cystic carcinoma cells by P53[J]. Basci Clin Med, 2005, 25(3):204-208.
[1] 孟玮,于振坤,郑雅丽,李光飞,梁龙君,王小敏. 术前模拟力学研究在拟植入耳赝附体先天性外中耳畸形患者中的应用价值[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 27-30.
[2] 孟立新,李健,韦善文. 鼓膜微管置入术治疗中耳不张76例临床分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 61-65.
[3] 周佳蕾,孙世冰,李晓艳. 婴幼儿宽频声导抗测试[J]. 山东大学耳鼻喉眼学报, 2018, 32(4): 91-94.
[4] 白永,尹迎春,韩学锋,尹兆富,李学忠. 头颈部低度恶性肌纤维母细胞肉瘤二例分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(4): 58-61.
[5] 谢日林,张志平. 布地奈德体位滴鼻治疗伴腺样体肥大的小儿分泌性中耳炎31例[J]. 山东大学耳鼻喉眼学报, 2018, 32(1): 65-67.
[6] 张孟璐,李永团. 继发性胆脂瘤中CCL27的定位及检测[J]. 山东大学耳鼻喉眼学报, 2017, 31(6): 46-48.
[7] 马钊恩, 翟锦明, 廖礼兵, 杨震. 咽鼓管球囊扩张术治疗慢性分泌性中耳炎的短期疗效观察[J]. 山东大学耳鼻喉眼学报, 2017, 31(5): 54-56.
[8] 郭颖媛,张德军,朱琳,马帅帅,管国芳. 一例中耳腺瘤的诊疗体会并文献复习[J]. 山东大学耳鼻喉眼学报, 2017, 31(3): 111-114.
[9] 吴允刚,张辉,刘黎明,庞太忠,李晓瑜. 鼓膜激光打孔治疗分泌性中耳炎20例[J]. 山东大学耳鼻喉眼学报, 2017, 31(1): 85-87.
[10] 孙娜综述,陈晓平审校. 咽喉反流与耳鼻咽喉科疾病[J]. 山东大学耳鼻喉眼学报, 2016, 30(6): 85-89.
[11] 曾婉婷,陈彦任,谭韵,李特,张民,关力谦,陈继川,姬长友,刘蓉蓉. 腮腺恶性肿瘤临床病理分析81例[J]. 山东大学耳鼻喉眼学报, 2016, 30(6): 104-106.
[12] 杜丽君,童军,陈文文,邓亚新,蔡勋华,单良. 单侧听力耳中耳炎手术经验再探讨[J]. 山东大学耳鼻喉眼学报, 2016, 30(6): 8-10.
[13] 刘斌,江育玲,肖旭平. 钛质人工听小骨在开放式鼓室成形术中的疗效观察与应用体会[J]. 山东大学耳鼻喉眼学报, 2016, 30(4): 80-83.
[14] 王晓燕,郑燕青,郑昊,叶青. 脉冲CO2激光与Er:YAG激光中耳骨消融的实验研究[J]. 山东大学耳鼻喉眼学报, 2016, 30(4): 75-79.
[15] 李兆生, 洪斌, 黄前进, 蒲伟民, 许振跃. 耳源性小脑脓肿2例并文献复习[J]. 山东大学耳鼻喉眼学报, 2015, 29(5): 32-37.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!