腮腺之上皮-肌上皮癌：一例報告

Epithelial-Myoepithelial Carcinoma of Parotid Gland : Report of A Case

唾液腺之上皮肌皮癌（epithelial-myoepithelial carcinoma），是一種非常少見的惡性腫瘤，大約佔所有唾液腺腫瘤的1%，主要好發於腮腺。此腫瘤特徵在於病理組織學上，可看到大部分是由兩種細胞所構成：內層呈管狀的上皮細胞（epithelial cell）和外層呈現明亮狀的肌上皮細胞（myoepithelial cell）。此兩種細胞通常表顯出高度分化型態。本科於1999年經歷一例，病患五年來因左側臉頰腮腺部位有一逐漸腫大且不痛之腫塊，電腦斷層掃描顯示左側腮腺淺葉區有一異質性腫塊，病患於是接受左側腮腺淺葉切除術。術後病理報告證實為上皮肌上皮癌。病患術後門診追蹤至今已1年6個月，腫瘤迄今無復發現象。由於此腫瘤在臨床上，有高復發率以及可能遠處轉移並致死的惡性表現，而且目前對於此腫瘤的預後因子尚未建立，因此術後的長期追蹤與觀察是絕對需要的。

Epithelial-myoepithelial carcinoma of salivary glands is a rare malignant tumor. It comprises about 1% of all salivary gland tumors, the parotid gland is the most common site of occurrence. The character of this neoplasm is the pathology revealed a biphasic cell arrangement formed by an inner layer of duct-linging epithelials and an outer layer of clear myoepithelial cells, and these neoplasm cells exhibit a high degree of cellular differentiation. In 1999, we have a 61-year-old woman who had noted a slowly growing, non-tender, and fixed mass over left parotid area for 5 years. The CT scan revealed a heterogenous mass over the superficial lobe of the left parotid gland. After superficial parotidectomy, the pathology revealed epithelial-myoepithelial carcinoma. After a follow-up of 1 year and 6 months, there have been no sign of recurrence. In clinically, this neoplasm has a higher frequency of recurrences, possibly distant metastases and even died of this neoplasm. In addition, the reliable prognostic markers are not established now, long-term follow-up is indispensable after treatment.