高齢者に発生した舌下腺原発腺様嚢胞癌の1例

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  • Adenoid cystic carcinoma occurred in sublingual gland of an elderly man: report of a case.

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Adenoid cystic carcinoma (ACC) is an uncommon tumor that may occur in head and neck. However, case reports of ACC occurring in the sublingual gland are rare. This paper reports on a case of ACC that occurred in the sublingular gland of an elderly man.<BR>An 80-year-old male whose chief complaint was paralysis and the induration from his left oral floor to the tongue was referred to our department. We found an elastic, hard fixed tumor measuring approximarely 27×15 mm in his left oral floor. Clinically, we diagnosed the tumor as a malignant tumor of oral the floor. A pathological investigation at biopsy was ACC. Under general anethesia, we performed the upper neck desection and local wide resection by the tracheotomy. During the operation, we resected the lingual and sublingual nerve for susepectednerve inversion. In addition, we found submandibular and submental lymph node metastasis, but limited desection of the neck to the upper neck region due to the patient's age. The surgical defect was reconstracted by the residual tongue. We chose postoperative radiation therapy. We are able to control local region and cervical lymph nodes but discovered multiple lung metastasis in a postoperative examination.<BR>A pathological investigation of the surgical specimen was ACC occurring in the sublingual gland with lymph node metastasis, venous invasion and perineural invasion.<BR>Eighteen cases (including this case) of ACC occurring in the sublingual gland have been reported in Japan to date. Usually, this tumor is wide resected with radical neck desection. However, we performd local wide resection and upper neck desection in an elderly patient to prevent postoperative problems and functonal lose.

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