耳下腺悪性腫瘍の取り扱い：針生検を用いた術前診断について

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  • Management of malignant parotid gland tumors: Preoperative evaluation with core needle biopsy

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Malignant tumors of the parotid gland are classified into various histological types, and their prognosis is significantly affected by the histological grade of malignancy, but preoperative evaluation of their grade is generally difficult. To improve the accuracy of preoperative pathological diagnosis, we have used core needle biopsy in cases in which there was suspicion suspected of a malignant tumor based on the clinical manifestations and imaging findings, including by dynamic MRI and ultrasonography. Extended total parotidectomy that included the sacrifice of the facial nerve followed by immediate nerve grafting was chosen in cases diagnosed as high-grade tumors. During the l0-year period from January 1996 to December in 2005, 49 cases of parotid gland cancer were treated at Chiba University Hospital. The accuracy of core needle biopsy and survival rates were assessed according to grade of histological malignancy and clinical stage. The accuracy of core needle biopsy (21 cases) was 95% (20/21) for malignancy, 76% (16/21) for histological malignancy grade, and 67% (14/21) for pathological diagnosis. According to clinical stage, the 5-years survival rate was 100% for stage I, 66.7% for stage II, and 54.5% for stage IV. According to histological grade, the 5-year survival rate was 100% for low/intermediate grade lesions and 61.5% for high grade lesions. Accurate preoperative diagnosis and consideration of histological grade are very important to the management of parotid gland cancer.<BR>We also describe our unique procedure for extended total parotidectomy.

収録刊行物

  • 口腔・咽頭科

    口腔・咽頭科 20 (3), 279-285, 2008

    日本口腔・咽頭科学会

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