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頁籤選單縮合
題名 | Gingival Metastasis from Gallbladder Cancer=膽囊癌的牙齦轉移 |
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作者 | 張德生; 廖宗琦; 李錦輝; 吳正雄; | 書刊名 | 長庚醫學 |
卷期 | 25:8 2002.08[民91.08] |
頁次 | 頁553-556 |
分類號 | 416.247 |
關鍵詞 | 膽囊癌; 轉移; 牙齦; Gallbladder cancer; Metastasis; Gingiva; |
語文 | 英文(English) |
中文摘要 | 膽囊癌是一種罕見的消化系惡性腫瘤,絕大多數病患在診斷時已經有遠處轉移,其中以肝臟轉移最常見,其次是局部淋巴系統;惡性腫瘤轉移至口腔部位的情況亦很少見,且大多是轉移至頷骨,轉移至軟組織者很少,轉移至口腔軟組織者其部位以牙齦較多,其次是舌頭,口腔軟組織轉移一般發生在疾病晚期,病人通常已有其他部位轉移,所以是個不良預後的表現。我們報告一例膽囊癌發生牙齦轉移的罕見病例,病人以腹痛症狀表現,在有症狀3個月後為膽結石施行剖腹膽囊切除術時才意外診斷膽囊癌,但當時已有包括肝臟、肺臟和骨頭的史移,再經1個月來到我們長庚紀念醫院時,理學檢查發現左上牙齦有一腫瘤,經病理檢查証實為膽囊癌轉移而來;病患對化學治療反應不佳,經三個療程化學治療,但效悲不佳,於診斷後5個月內死於原發部腫瘤增長併阻塞黃疸又大量右助膜積水致呼吸衰竭。 |
英文摘要 | Gallbladder cancer is generally diagnosed at an advanced stage. The liver is the most commonly invaded organ by direct extension and/or metastasis, followed by regional lymph nodes. Oral soft tissue metastasis is extremely unusual. This report describes the case of a 62-yar-old woman diagnosed with advanced metastatic gallbladder cancer, who initially presented with abdominal pain. Diagnosis of gallbladder caner was made about 3 months after her symptoms developed, when a laparoscopic cholecystectomy was performed because of the suspicion of gallstones. Liver metastasis was also discovered during surgery. A postoperative investigation revealed additional lung and bone metastases. A visible left gingival tumor was found on physical examination and was confirmed as gallbladder cancer metastasis by compatible histopathology 1 month after surgery. The patient responded poorly to chemotherapy and unfortunately died 5 months after the diagnosis. The clinical presentation of gallbladder cancer was relatively typical, apart from the unusual gingival metastasis. The medical literature contains quite a few examples of metastatic lesions located strictly in the oral soft tissue, however no case of gallbladder cancer metastasizing to the oral soft tissue has been previously reported. |
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