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Case Presentation

Case Presentation. SKKU School of Medicine Otorhinolaryngology, Head and Neck Surgery 2007313075 Son Eui Young. Chief Complaint. M / 52 Right infraauricular mass Onset(remote) : 4YA. Present illness. 2009-04-27(3YA)

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Case Presentation

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  1. Case Presentation SKKU School of Medicine Otorhinolaryngology, Head and Neck Surgery 2007313075 Son Eui Young

  2. Chief Complaint • M / 52 • Right infraauricular mass • Onset(remote) : 4YA Page 2

  3. Present illness • 2009-04-27(3YA) • 약 1년전 우연히 발견한 right infraauricular mass로 size 증가하여 SMC ENT 외래로 내원. 진찰 상 크기 약 1cm • 2009-06-03 • Salivary CT상 3cm의 mass 보임. FNAB에서 pleomorphic adenoma • 수술 예정이었으나 환자 원하여 delayed Page 3

  4. Present illness • 2012-02-08 (3MA) • 수술 위해 ENT 외래로 재내원함. P/Ex 상 hard, mobile, about 2cm mass • 2012-02-24 • Superficial parotidectomy 예정, 수술 날짜 결정 • 2012-05-07 • 수술 위해 입원 Page 4

  5. Other Histories • Past Medical History • Hypertension (+) : 15YA, on medication • DM (-), Hepatitis (-), Tb(-), Alllergy(-), antibiotics allergy(-) • Social History • Alcohol (+), Smoking (+) Page 5

  6. Review of System • General • General weakness (-), Fever(-) • Ear • Itching sense(-/+) (1MA) Page 6

  7. Physical Exam • General • General appearance : not so ill looking • Mental status : alert • Neck Page 7

  8. Imaging 2.9 x 1.7 x 1.9 cm lobulating solid mass in the right parotid gland, aspiration. US Page 8

  9. FNA guided Biopsy Page 9

  10. Imaging Salivary gland CT Page 10

  11. Imaging Salivary gland CT Page 11

  12. Imaging Salivary gland CT Page 12

  13. Problem List #1. Right infraauricular mass #2. Underlying Hypertension Page 13

  14. 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

  15. Hospital Course • POD #0 • V/S stable, Pain tolerable • Wound clear, no immediate complication • family nurse practitioner (-) Page 15

  16. Disease Review Salivary gland tumor 2007313075 Son Eui Young

  17. 역학 Page 17

  18. 병리조직학적 분류 Page 18

  19. 임상양상 Page 19

  20. 진단 Page 20

  21. 병기 Page 21

  22. 다형선종 (Pleomorphic adenoma) Page 22

  23. 치료원칙 & 예후 Page 23

  24. 이하선 절제술 Page 24

  25. Reference • <이비인후과학, 두경부외과학> 개정판, 일조각 • Vol II, Chapter 2, Chapter 7 Page 25

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