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Published byJoanna Horn Modified 6년 전
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Case Presentation SKKU School of Medicine Otorhinolaryngology, Head and Neck Surgery Son Eui Young 1
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Chief Complaint M / 52 Right infraauricular mass Onset(remote) : 4YA
환자분 71세 남자로 40년전부터 생긴 왼쪽에 생긴 비폐색을 주소로 내원하였습니다. Page 2
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Present illness 2009-04-27(3YA) 2009-06-03
약 1년전 우연히 발견한 right infraauricular mass로 size 증가하여 SMC ENT 외래로 내원. 진찰 상 크기 약 1cm Salivary CT상 3cm의 mass 보임. FNAB에서 pleomorphic adenoma 수술 예정이었으나 환자 원하여 delayed Page 3
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Present illness 2012-02-08 (3MA) 2012-02-24 2012-05-07
수술 위해 ENT 외래로 재내원함. P/Ex 상 hard, mobile, about 2cm mass Superficial parotidectomy 예정, 수술 날짜 결정 수술 위해 입원 Page 4
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Other Histories Past Medical History Social History
Hypertension (+) : 15YA, on medication DM (-), Hepatitis (-), Tb(-), Alllergy(-), antibiotics allergy(-) Social History Alcohol (+), Smoking (+) Page 5
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Review of System General Ear General weakness (-), Fever(-)
Itching sense(-/+) (1MA) PND : postnasal drip Sneezing 재채기 Itching 가려움 Autophonia 자성강청, 내 목소리가 크게 들리는거 Page 6
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Physical Exam General Neck General appearance : not so ill looking
Mental status : alert Neck Page 7
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Imaging 2.9 x 1.7 x 1.9 cm lobulating solid mass in the right parotid gland, aspiration. US 2.9 x x cm lobulating solid mass in the right parotid gland, aspiration. Page 8
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FNA guided Biopsy 2.9 x x cm lobulating solid mass in the right parotid gland, aspiration. Page 9
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Imaging Salivary gland CT Page 10
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Imaging Salivary gland CT Page 11
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Imaging Salivary gland CT Page 12
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Problem List #1. Right infraauricular mass #2. Underlying Hypertension
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Assessment & Operation
Right parotid gland mass r/o pleomorphic adenoma r/o Warthin’s tumor Total parotidectomy with facial nerve preservation(Right) Histopathologic type : pleomorphic adenoma Tumor size : 3cm Greater auricular n. : Ant. branch (saved) Post. branch (saved) Facial n. : Zygomatic branch (saved) Temporal branch (saved) Buccal branch (saved) Marginal mandibular branch (saved) Cervical branch (saved) Stenson's duct : ligated Page 14
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Hospital Course POD #0 V/S stable, Pain tolerable
Wound clear, no immediate complication family nurse practitioner (-) Page 15
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Salivary gland tumor 2007313075 Son Eui Young
Disease Review Salivary gland tumor Son Eui Young 16
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역학 Page 17
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병리조직학적 분류 Page 18
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임상양상 Page 19
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진단 Page 20
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병기 Page 21
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다형선종 (Pleomorphic adenoma)
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치료원칙 & 예후 Page 23
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이하선 절제술 Page 24
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Reference <이비인후과학, 두경부외과학> 개정판, 일조각 Vol II, Chapter 2, Chapter 7
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