中耳耵聍腺肿瘤3例并文献复习

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.

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

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.