转移到腮腺

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引用次数: 0

摘要

转移到腮腺的癌是一种区域特异性疾病。病史通常显示既往皮肤鳞状细胞癌(SCC)或黑色素瘤。体格检查可显示既往手术留下的疤痕、当前头颈部病变、相关淋巴结病变和感觉改变。检查包括纤维鼻内窥镜,细针穿刺细胞学,计算机断层扫描,磁共振成像和正电子发射断层扫描。治疗方案包括手术(消融/重建)、放疗(适用于鳞状细胞癌和黑色素瘤)、化疗(适用于鳞状细胞癌)、化学免疫治疗(可能对黑色素瘤有作用)。需要避免的并发症包括:(1)伤口相关并发症(皮瓣坏死、皮瓣“钮扣孔”形成),(2)肿瘤相关并发症(伴有颈部疾病、肿瘤破裂、局部肿瘤复发患者术前调查不充分或遗漏颈部清扫手术不当),(3)腺体相关并发症(唾液瘘、涎腺囊肿),(4)神经相关并发症(面神经损伤,弗雷氏综合征或味觉出汗,以及大耳神经瘤)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cancer Metastatic to the Parotid Gland
Carcinoma metastatic to the parotid gland is a region-specific disorder. History usually reveals a previous cutaneous squamous cell carcinoma (SCC) or melanoma. Physical examination may show scars of previous operations, current head and neck lesions, associated lymphadenopathy, and altered sensation. Investigations include fiberoptic naso-endoscopy, fine needle aspiration cytology, computed tomography scan, magnetic resonance imaging, and positron emission tomography. Treatment options include surgery (ablative/reconstructive), radiotherapy (indicated for SCC and melanoma), chemotherapy (indicated for SCC), chemo-immunotherapy (may have a role for melanoma). Complications to avoid include (1) wound-related complications (skin flap necrosis and skin flap “button-hole” formation), (2) tumor-related complications (inappropriate surgery due to inadequate preoperative investigation or omitting neck dissection in patients with concomitant neck disease, tumor rupture, and local tumor recurrence), (3) gland-related complications (salivary fistula and sialocele), and (4) nerve-related complications (facial nerve injury, Frey's syndrome or gustatory sweating, and great auricular nerve neuroma).
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