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109
症 例 北里医学 2016; 46: 109-115
Received 15 February 2016, accepted 24 June 2016連絡先: 那須野智光 (東芝林間病院耳鼻咽喉科)〒252-0302 神奈川県相模原市南区上鶴間7-9-1E-mail: [email protected]
Figure 1. Ultrasound (A) and color flow Doppler (CFD) (B) images of the tumor. CFD image (B) showedabundant blood flowing in the tumor.
Figure 2. Computed tomography images of the neck (A: plain, B: enhanced). The tumor (arrow) was iso-dense with parotid gland on plain CT (A) and well-circumscribed, homogeneous enhancement (arrow) onenhanced CT (B).
Figure 4. Histological images of the tumor (H&E stain, A: low-power field, B: high-power field). Lowpower photomicrograph (A) showed spindle-shaped tumor cells arranged in a haphazard or so-called patternlesspattern. High-power photomicrograph (B) showed numerous staghorn-like vessels (arrows).
Figure 5. Immunohistochemical staining of the tumor (high-power field, A: vimentin, B: CD34). Thesespindle cells are immunoactive with vimentin (A) and CD34 (B).
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Table 1. Clinical data of 33 parotid solitary fibrous tumor cases in the current literature
症例 報告者 年度 年齢 性別 大きさ (cm) 治療 経過
1 Hanau, et al.18 1995 73 F 3.5 外科的切除 4年再発なし
2 Ferriro, et al.18 1996 78 F 1.0 外科的切除 1年再発なし
3 同上18 1996 46 M 4.4 外科的切除 0.1年再発なし
4 Sato, et al.18 1998 52 M 12.0 外科的切除 1年再発なし
5 Brunnemann, et al.18 1999 43 M 2.0 外科的切除 不明
6 同上18 1999 66 F 2.7 外科的切除 4.7年再発なし
7 Mohammed, et al.18 2001 42 F 2.2 外科的切除 0.2年再発なし
8 藤森ら14 2001 60 M 不明 外科的切除 不明
9 Guerra, et al.18 2002 37 F 7.0 外科的切除 1年再発なし
10 Kumagai, et al.18 2002 47 F 4.2 外科的切除 1.2年再発なし
11 Thompson, et al.18 2004 11 F 4.0 外科的切除 2年再発なし
12 Gerhard, et al.18 2004 34 F 4.0 外科的切除 2年再発なし
13 Suarez Roa, et al.47 2004 20 F 10.0 & 1.8 外科的切除 & 放射線治療 1年再発なし
14 立花ら16 2004 29 F 3.4 外科的切除 2.8年再発なし
15 光澤ら15 2004 65 F 不明 外科的切除 & 放射線治療 2年再発なし
16 Wiriosuparto, et al.18 2005 42 M 6.5 外科的切除 不明
17 Kim, et al.18 2005 59 M 不明 外科的切除 0.6年再発なし
18 Sreetharan, et al.18 2005 44 M 1.0 外科的切除 1年再発なし
19 Ridder, et al.18 2007 24 M 4.4 外科的切除 不明
20 平野ら17 2007 30 F 3.0 外科的切除 2.2年再発なし
21 Takahama, et al.18 2008 73 F 3.0 外科的切除 1.8年再発なし
22 Cho, et al.18 2008 58 M 6.5 外科的切除 5.6年再発なし
23 Manglik, et al.18 2008 79 M 2.4 外科的切除 0.3年再発なし
24 Yang, et al.46 2009 54 M 5.0 外科的切除 & 放射線治療 不明
25 Messa-Botero, et al.18 2011 78 F 3.9 外科的切除 0.6年再発なし
26 Iyengar, et al.19 2011 43 M 4.0 外科的切除 不明
27 Justin, et al.18 2012 66 M 4.3 外科的切除 0.8年再発なし
28 Cristofaro, et al.20 2012 38 M 3.8 外科的切除 5年再発なし
29 Sousa, et al.21 2013 42 M 4.0 外科的切除 0.8年再発なし
30 Alonso-Rodríguez, et al.24 2014 73 F 2.0 外科的切除 2年後再発あり
31 Kwok, et al.22 2015 28 M 2.7 外科的切除 不明
32 Yu, et al.23 2015 53 M 2.0 外科的手術 2年再発なし
33 本症例 2016 48 F 1.6 外科的切除 10年再発なし
Table 2. Imaging features of SFT, cavernous hemangioma and basal cell adenoma
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A case of solitary fibrous tumor of the parotid gland
1Department of Otorhinolaryngology, Toshiba Rinkan Hospital2Hashimoto Tower Otorhinolaryngology3Department of Otorhinolaryngology, Kitasato Medical Center4Department of Otorhinolaryngology-Head and Neck Surgery, Kitasato University School of Medicine5Department of Otorhinolaryngology, Sagamihara National Hospital
Solitary fibrous tumor (SFT) is a mesenchymal neoplasm, and the most common site is the pleura. SFT in thehead and neck lesion is rare. We reported an SFT from the parotid gland. A 48-year old woman complainedof right-sided subauricular swelling. Ultrasound examination and contrast-enhanced computed tomographyrevealed a well-defined tumor with abundant blood flow. The patient underwent a right superficialparotidectomy. Histological examination revealed that the spindle cells were arranged in a random pattern,known as a "patternless pattern," and thin-walled branching vessels, "staghorn." Additionally,immunohistochemical study showed a strong positivity of vimentin and CD34. From the above findings, thistumor was diagnosed as SFT. Her postoperative course was uneventful, and she remains free from disease 10years after the surgery.
Key words: solitary fibrous tumor, parotid gland, immnohistological test, head and neck lesion
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