mixed parotid tumor
Introduction
Brief introduction of parotid mixed tumor A mixed tumor of the parotid gland or a polymorphic adenoma is a parotid tumor containing parotid tissue, mucus and cartilage-like tissue, so it is called a "mixed tumor." The mucus and cartilage-like tissue are metamorphosed by glandular tissue. The outer layer of the tumor is a thin layer of envelope, which is formed by deformation of the parotid gland after compression, and is not a true envelope. Parotid mixed tumors are more common in middle age. Generally, there are no obvious symptoms, and the growth is slow, and the course of disease can last for several years or even decades. basic knowledge The proportion of illness: 0.005% Susceptible people: no special people Mode of infection: non-infectious Complications: facial nerve injury
Cause
Parotid mixed tumor etiology
Cause (97%):
A mixed tumor of the parotid gland or a polymorphic adenoma is a kind of parotid gland tumor containing parotid gland tissue, mucus and cartilage-like tissue. It is called a "mixed tumor", in which mucus and cartilage-like tissue are metamorphosed by glandular tissue. The outer layer is a very thin envelope formed by the deformation of the parotid gland tissue. It is not a true capsule. Although the parotid mixed tumor is benign, it has potential malignant biological behaviors, such as tumor cell infiltration. Therefore, clinically, the mixed tumor of the parotid gland is regarded as a "critical tumor", that is, a tumor between benign and malignant, about 5% to 10% can undergo malignant transformation.
Prevention
Parotid mixed tumor prevention
1, reasonable diet: can eat more high-fiber and fresh vegetables and fruits, balanced nutrition, including protein, sugar, fat, vitamins, trace elements and dietary fiber and other essential nutrients, meat and vegetables, diversified food varieties To give full play to the complementary role of nutrients in food.
2, to maintain oral health, timely treatment of related diseases and inflammation. Oral inflammation and pathogens stimulate the parotid gland for a long time, which is easy to cause disease.
Complication
Parotid mixed tumor complications Complications facial nerve injury
Complications of parotid mixed tumors are associated with pain, facial paralysis, and the like.
Symptom
Parotid mixed tumor symptoms Common symptoms Parenchyma lumbosacral palsy
The mixed tumor of the parotid gland is more common in young adults. The tumor is located below the earlobe. When it is larger, it extends to the neck. The tumor is hard nodular, and sometimes some of them have cystic changes with soft nodules, tumors and skin or The basal tissue has no adhesion and can be pushed; the growth is slow, and it can not change for several years or more than ten years. If malignant transformation occurs, the tumor often grows suddenly and adheres to the surrounding tissue, and the advanced malignant tumor can be broken. Symptoms such as pain or facial paralysis, and lymph node metastasis in the cervical region.
Mixed tumors of the parotid gland are more common in middle age. Generally, there are no obvious symptoms. The growth is slow, and the course of disease can reach several years or even decades. The tumors are mostly characterized by a tough mass in the subarachnoid area with nodular surface and clear boundary. Medium hardness, no adhesion to surrounding tissues, mobility, no tenderness. If one of the following conditions occurs, the possibility of malignant transformation should be considered. 1 The sudden increase of tumor rapidly increases, 2 the mobility is reduced or even fixed, 3 is painful or Same side, etc.
Examine
Parotid mixed tumor examination
The diagnosis of parotid mixed tumor is based on comprehensive medical history and local physical examination. CT examination is required before surgery. CT: regular shape, mostly round or elliptical, with clear boundaries, smooth edges, uniform density, surrounding The subcutaneous fat layer is clear, and the masseter muscle, the pterygoid muscle, the sternocleidomastoid muscle, and the posterior abdomen of the second abdominal muscle are clearly visible. Final pathological examination to confirm the diagnosis.
Diagnosis
Diagnosis and differentiation of parotid mixed tumor
It is generally up to the actual condition of the patient. Differential diagnosis
1. Chronic lymphadenitis in the parotid gland
Often manifested as a painless mass, especially in the jaw, but all have a history of infection, such as the history of inflammation of the face, mouth or pharynx, lymphadenitis often sometimes large and small history and acute history, anti-infective treatment effective.
2, parotid lymph node
Mainly due to tuberculous infection of the lymph nodes in the parotid gland, most of the tuberculosis of the head and neck skin, oropharynx, especially the tonsils, is caused by lymph node drainage. The mass of the tumor grows slowly, sometimes with a small history, occasionally mild pain or tenderness, and is significantly reduced after treatment with anti-tuberculosis drugs. Tuberculin experiments are often positive. If it is a glandular tuberculosis, the gland is diffusely enlarged, and the purulent discharge from the extruded gland is seen to flow out from the catheter. The mass can be hard or soft, and it can also be fluctuating.
3, parotid gland lymphoma
More common in men, smaller in size, usually located in the lower or lower part of the parotid gland, often multifocal. B-ultrasound examination of its sonogram is characterized by a complete envelope echo band, internal echo is stronger than the parotid mixed tumor, the back wall echo is more neat, round, smooth border, internal grid-like and uniform A hypoechoic mass that helps identify the mixed tumor with the parotid gland. The thermal nodules of TC radionuclide imaging are important differential diagnostic features.
4, the first cervical vertebrae transverse hypertrophy
For a hard mass, it can be paralyzed at the midpoint of the mastoid tip to the mandibular angle. It is often misdiagnosed as a deep parotid tumor of the parotid gland. The hypertrophic transverse process is deep and hard and inactive. The diagnosis can be confirmed by comparing the two sides with X-ray film.
5, parotid cyst
Parotid cysts are divided into two types: retention and congenital. It is characterized by a painless mass in the parotid gland. In the case of retention cysts, the tumor is soft and has a sense of fluctuating. The puncture can extract the cyst fluid, which contains amylase. B-ultrasound is a cystic image with a clear perimeter, and a layer of obvious strong echo envelope light band is visible around it. The internal echo is a liquid dark area.
In congenital cysts, epidermoid cysts located deep in the parotid gland sometimes need to be differentiated from parotid mixed tumors. It is characterized by a soft texture and uniformity, and the puncture can extract sebum-like substances. Needle aspiration cytology can be seen in well-differentiated epidermal-like cells.
