以腮腺腫塊為表現的原發性食道小細胞癌－－病例報告

Primary Esophageal Small Cell Carcinoma Presenting with Parotid Gland Metastatic tumor- Report of A Case

小細胞癌(small cell carcinoma)最常見於肺部，發生於肺以外的器官相當少見，其侵犯性強且癒後很差。本病例是一名78歲男性，因右側耳下區有一腫塊，在兩個月內快速增大，於是到本院耳鼻喉科門診求診。理學檢查後安排電腦斷層掃描，初步臆斷爲腮腺之惡性腫瘤，於是安排腮腺切除手術，術中冰凍切片報告爲罕見的小細胞癌。術後經一系列完整的檢查後，診斷爲原發自食道之小細胞癌，具有腮腺、肝臟及腎上腺之多處轉移。於是安排化學治療，並接受放射線治療。病患於數月後仍因腫瘤多發轉移及敗血性休克而死亡。因案例罕見，故提出報告以供參考。

Small cell carcinoma is frequently found in the lung. Extra pulmonary sites of this neoplasm is rarely noted. It is an aggressive tumor associated with a poor prognosis. We report a 77-year-old male presenting with right side preauricular mass with rapid progression in two months. Therefore, right parotidectomy was performed under the impression of malignancy and the frozen section examination revealed small cell carcinoma. A complete work up was arranged to search for primary origin and the final diagnosis was esophageal small cell carcinoma with right parotid gland, liver and right adrenal gland metastasis. Subsequent chemotherapy and radiotherapy were performed, but he expired 7 months after diagnosis due to multiple metastases and septic shock.