口腔診斷學.pptVIP

Mass of the Neck CT Findings Petrous effect Ref. 6 Features Suggestive of Benignancy Movable (except palate) Unattached to skin or mucosa (except palate) No ulceration of skin or mucosa Slow growth Long duration No pain No facial nerve palsy Features Suggestive of Malignancy Induration Fixed to overlying skin or mucosa Ulceration of skin or mucosa Rapid growth; Growth spurt Short duration Pain, often severe Facial nerve palsy Ref. 6 Infection or Benign / Malignant Pain (-) Growing slowly (5~6 years) Smooth surface CT findings : demarcated margin No other structure destruction Mass of the Neck ? Benign Tumor Working Diagnoses Pleomorphic Adenoma Warthin’s Tumor Basal Cell Adenoma Oncocytoma Mass of the Neck Mass of the Neck Pleomorphic Adenoma 53% ~ 77% of parotid tumors Painless, slow growing, firm mass Facial palsy pain are rare Age: 30 ~ 50 y/o Slight female predilection Warthin’s Tumor Occurs almost exclusively in the parotid gland 5 % ~ 14 % of parotid tumors Slow-growing, nodular mass Firm to fluctuant to palpation Bilateral occurrence (5-14%) Age: older adults, 51-70 y/o Associated with smoking Mass of the Neck Mass of the Neck Basal Cell Adenoma Parotid (75%) ? 1st , minor glands ? 2nd (esp. upper lip, buccal mucosa) Age: middle-aged、older adults、61~70 (most) Sex predilection: female ( female : male = 2:1 in some study) Slow growing, freely movable mass, similar to pleomorphic adenoma Most tumors are less than 3 cm in diameter 1% of all salivary gland tumor Oncocytoma Painless, slow growing, Firm mass rarely 4cm 80% in parotid gland Older adults, 71~80 (peak) Slight female predilection Occurrence: 1% of all salivary gland tumor Mass of the Neck Pleomorphic Adenoma, right parotid gland Clinical Impression Mass of the Neck Mass of the Neck Excisional Biopsy Ref. 6 Mass of the Neck Excisional Biopsy Ref. 6 Mass of the Neck Excisional Biopsy Ref. 6 Mass of the Neck Excisi