PDF(Pubmed)
Abstract：
OBJECTIVE: First bite syndrome (FBS) is a symptom of severe pain at the beginning of a meal that lessens as the meal progresses. It is a common postoperative complication of parapharyngeal space tumors and is rarely reported as the first symptom of parotid carcinoma. The parapharyngeal space is considered a difficult area for approach; hence, preoperative histopathology is often challenging. However, there are hardly any reports on the approach of performing biopsies under computerized tomography (CT) guidance.
METHODS: A 28-year-old woman presented to our hospital with the chief complaint of pain in the left parotid region since the past year. Contrast-enhanced magnetic resonance imaging of the parotid gland revealed a 10-mm high-signal area on T2-weighted images extending from the deep lobe of the left parotid gland to the parapharyngeal space, which could not be visualized on ultrasound. She was suspected to have a malignant tumor because of the presence of a parotid tumor with FBS. Therefore, she underwent CT-guided fine-needle aspiration cytology (FNAC) and was diagnosed with adenoid cystic carcinoma. The patient underwent left parotid tumor resection and left cervical dissection, and her pain during feeding improved postoperatively.
CONCLUSIONS: In a patient with parotid tumor extending into the parapharyngeal space with FBS as the initial symptom, CT-guided FNAC was successfully used to diagnose parotid carcinoma. Symptoms of pain, including FBS, should be considered in cases of malignancy. CT-guided FNAC is effective for lesions that cannot be visualized by ultrasound, such as those in the parapharyngeal space.
METHODS: A 28-year-old woman presented to our hospital with the chief complaint of pain in the left parotid region since the past year. Contrast-enhanced magnetic resonance imaging of the parotid gland revealed a 10-mm high-signal area on T2-weighted images extending from the deep lobe of the left parotid gland to the parapharyngeal space, which could not be visualized on ultrasound. She was suspected to have a malignant tumor because of the presence of a parotid tumor with FBS. Therefore, she underwent CT-guided fine-needle aspiration cytology (FNAC) and was diagnosed with adenoid cystic carcinoma. The patient underwent left parotid tumor resection and left cervical dissection, and her pain during feeding improved postoperatively.
CONCLUSIONS: In a patient with parotid tumor extending into the parapharyngeal space with FBS as the initial symptom, CT-guided FNAC was successfully used to diagnose parotid carcinoma. Symptoms of pain, including FBS, should be considered in cases of malignancy. CT-guided FNAC is effective for lesions that cannot be visualized by ultrasound, such as those in the parapharyngeal space.
摘要：
目的：首次咬伤综合征（FBS）是在进餐开始时剧烈疼痛的症状，随着进餐的进展而减轻。它是咽旁间隙肿瘤的常见术后并发症，很少报道为腮腺癌的首发症状。咽旁间隙被认为是难以进入的区域；因此，术前组织病理学通常具有挑战性。然而,几乎没有关于在计算机断层扫描(CT)指导下进行活检的方法的报道.
方法：一名28岁的妇女在过去一年来我院就诊，主诉为左侧腮腺区疼痛。腮腺的对比增强磁共振成像显示，T2加权图像上有一个10毫米的高信号区域，从左腮腺的深叶延伸到咽旁间隙，无法在超声波上看到。由于存在伴有FBS的腮腺肿瘤，她被怀疑患有恶性肿瘤。因此,患者接受了CT引导下细针穿刺细胞学检查(FNAC),并被诊断为腺样囊性癌.患者行左腮腺肿瘤切除术和左颈淋巴结清扫术，她在进食过程中的疼痛在术后得到改善。
结论：在以FBS为首发症状的腮腺肿瘤扩展到咽旁间隙的患者中，CT引导下FNAC已成功诊断腮腺癌。疼痛的症状，包括FBS,在恶性肿瘤的情况下应考虑。CT引导下的FNAC对超声无法可视化的病变有效，比如咽旁空间。
方法：一名28岁的妇女在过去一年来我院就诊，主诉为左侧腮腺区疼痛。腮腺的对比增强磁共振成像显示，T2加权图像上有一个10毫米的高信号区域，从左腮腺的深叶延伸到咽旁间隙，无法在超声波上看到。由于存在伴有FBS的腮腺肿瘤，她被怀疑患有恶性肿瘤。因此,患者接受了CT引导下细针穿刺细胞学检查(FNAC),并被诊断为腺样囊性癌.患者行左腮腺肿瘤切除术和左颈淋巴结清扫术，她在进食过程中的疼痛在术后得到改善。
结论：在以FBS为首发症状的腮腺肿瘤扩展到咽旁间隙的患者中，CT引导下FNAC已成功诊断腮腺癌。疼痛的症状，包括FBS,在恶性肿瘤的情况下应考虑。CT引导下的FNAC对超声无法可视化的病变有效，比如咽旁空间。
