Acinic cell carcinoma ślinianki przyusznej o nietypowym obrazie klinicznym i niekorzystnym przebiegu
Journal Title: Otolaryngologia Polska - Year 2009, Vol 63, Issue 5
Abstract
Differential diagnosis of neck tumours puts precedence on diagnosing neoplastic lesions. In the case of neck tumours, these are unfortunately late signs , but in patients with a primary neoplastic focus within the head and neck, neck tumour is often the fi rst sign of the disease. The authors describe a clinical case of neck tumour with initially unclear etiology. The preoperative diagnostics including ultrasonography, thin-needle puncture, MRI, carotid angiography and videostrobos copy was signifi cant for surgical treatment planning; yet it was the intraoperative clinical picture which indicated that the tumour derived from the inferior parotid pole. The preoperative histopathological diagnosis using thin- needle biopsy: cellulae carcinomatosae and the clinical picture resulted in block operation with neck lymphatic system removal and tissue defect reconstruction by means of a pectoral fl ap. The histopathological examination confi rmed non-cornifying basal cell epithelioma only in the essential lesion with no metastases to lymph nodes and surrounding tissue margins free of infi ltrates. Two and a half years after the procedure,the patient presented with a tumour localized on the front thoracic wall and two rapidly enlarging tumours in the nape of the neck.In the collected specimen of the tumour on the front thoracic wall, a diagnosis of acinic cell carcinoma was made. The deteriorating general condition of the patient, his cancer emaciation , problems with movement and suspected liver metastases confi rmed by abdominal USG as well as radiological bone lesions resulted in the abandonment of surgical treatment due to disseminated neoplastic process and the patient was referred for palliative care.
Authors and Affiliations
Józef Komorski, Jan Nienartowicz
Keywords
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