PDF(Pubmed)
Abstract：
At our institution, radiation oncologists routinely treat early-stage oral cancer with low-dose-rate brachytherapy (LDR-BRT) using Au-198 grains. In this report, we show a unique case of a patient with a gold grain located within the submandibular gland, found incidentally during follow-up after LDR-BRT for floor of mouth cancer. One month after the implant, he showed sialadenitis-like symptoms, but the pain resolved two months later. All the grains were detected around the anterior sublingual area by computed tomography (CT) four months after the implant. Unexpectedly, 11 months after the implant, CT revealed that a grain was located in an intraglandular site of the submandibular gland. This finding clearly demonstrates that the grain entered Wharton\'s duct and retrogradely migrated to the submandibular gland through the duct. As a mechanism of the calculus formation within Wharton\'s duct, retrograde migration of foreign bodies to the inside of the duct has been proposed. Our incidental finding after LDR-BRT highlights the need for monitoring post-LDR-BRT using Au-198 grains for the treatment of floor of mouth cancer and sheds additional light on retrograde theory within Wharton\'s duct.
摘要：
在我们的机构，放射肿瘤学家通常使用Au-198颗粒进行低剂量率近距离放射治疗（LDR-BRT）治疗早期口腔癌。在这份报告中,我们展示了一个独特的病例，患者的下颌下腺内有一个金粒，在LDR-BRT治疗口腔地板癌后的随访中偶然发现。植入后一个月，他表现出唾液腺炎样症状,但两个月后疼痛缓解了.植入后四个月，通过计算机断层扫描（CT）在舌下前区周围检测到所有颗粒。出乎意料的是,植入后11个月，CT显示谷物位于下颌下腺的颗粒内。这一发现清楚地表明，谷物进入沃顿的导管，并通过导管逆行迁移到下颌下腺。作为沃顿波导内微积分形成的一种机制，已经提出了异物向管道内部的逆行迁移。我们在LDR-BRT后的偶然发现强调了使用Au-198颗粒治疗口腔癌的LDR-BRT后监测LDR-BRT的必要性，并进一步阐明了沃顿商学院内的逆行理论。
