Mixed tumor

Introduction to mixed tumor A mixed tumor refers to a tumor formed by two or more new biological tissue structures. Various benign tumors can occur in the oral and maxillofacial regions. Occurs in soft tissue, such as mixed tumors of the parotid gland, gingival tumor, hemangioma, lymphangioma, neurofibromatosis, fibroids, etc. Occurred in bone tissue, such as giant cell tumor, osteoma and so on. Some orthotopic tumors in the oral and maxillofacial regions are associated with odontogenic tissues, and are odontogenic tumors such as dental tumors and ameloblastomas. basic knowledge The proportion of illness: 0.001% Susceptible people: no specific population Mode of infection: non-infectious Complications: lacrimal gland mixed tumor

Mixed tumor cause

Disease factor (95%)

The mixed tumor of the parotid gland is one of the most common tumors in the oral and maxillofacial region. It is derived from the epithelium of the parotid gland. In addition to the epithelial component, there are often mucus and cartilage-like tissues in the tumor. The mixed tumor of the parotid gland occurs in the parotid gland, followed by The ankle and submandibular gland are described below with the mixed tumor of the parotid gland as an example to describe its clinical manifestations and treatment principles.

Mixed tumor prevention

For the prophylactic anti-infection of general surgery, sulfa drugs (such as compound sulfamethoxazole) or drugs mainly acting on Gram-positive bacteria (such as erythromycin, penicillin, etc.) are used. People with poor constitution or concurrent infections often use drugs. More commonly used: drugs that act on Gram-positive bacteria (such as penicillin) plus drugs that act on Gram-negative bacteria (such as gentamicin) plus drugs that act on anaerobic bacteria (such as metronidazole); surgery Patients with severe infections or complications before and after can choose effective antibiotics according to clinical and drug susceptibility tests.

The mixed tumor of the parotid gland must be treated surgically. It is not sensitive to radiation and generally cannot be treated with radiotherapy. Because the tumor is a critical tumor, the tumor can survive for a long time or improper treatment, and it can cause malignant transformation. Therefore, once the tumor of the parotid gland is found, Surgical resection should be promptly performed. It is forbidden to use some externally applied drugs with unknown ingredients. The tumor generally grows slowly and can be asymptomatic for a long time. However, if growth is accelerated, the hardness increases, etc., it means malignant transformation, and surgery should be performed immediately, but the operation after malignant transformation The prognosis is far less than the prognosis of benign surgery.

Mixed tumor complications Complications

In addition to the structure of benign lacrimal gland mixed tumor, the tumor tissue also has a cancerous tissue structure. The tumor tissue infiltrates into the sputum, destroys the bone, and can cause systemic metastasis. In severe cases, it is transferred to the brain and is life-threatening.

Mixed tumor symptoms Common symptoms Slow-growing facial muscle weakness, nodular mass in the subarachnoid area

Mixed tumors of the parotid gland are more common in middle age. Generally, there are no obvious symptoms. The growth is slow, and the course of disease can reach several years or even decades. The tumors are mostly characterized by a tough mass in the subarachnoid area with nodular surface and clear boundary. Moderate hardness, no adhesion to surrounding tissues, mobility, no tenderness, such as the presence of one of the following conditions, should consider the possibility of malignant transformation.

1 The sudden increase in tumors is rapidly increasing.

2 mobility is reduced or even fixed.

3 There is pain or ipsilateral sputum.

Hybrid tumor examination

X-ray examination

Because many modern imaging examinations such as ultrasound and CT are commonly used, and soft tissue lesions are superior to traditional X-rays. However, the latter is still characteristic for the diagnosis of pleomorphic adenomas. The X-ray can be displayed (20o posterior position), the sacral cavity is enlarged or the lacrimal gland is bulging outward and upward, and the boundary is clear and tidy without bone destruction. Because the tumor is located in the lacrimal gland adjacent to the bone wall and is restricted by the bone wall and the eyeball, after the tumor grows, the lacrimal gland is first compressed, causing the lacrimal gland to expand outward. This type of X-ray sign has a qualitative diagnostic value.

Ultrasonography

A typical benign pleomorphic adenoma B-ultrasound is a round or round-like lesion in the upper part of the iliac crest. The boundary is clear and smooth, the inner echo is more or moderately distributed, the sound attenuation is moderate, and there is no compressibility. Due to the enlargement of the lacrimal gland caused by tumor compression, it appears on the B-ultrasound as a posterior prominent part of the posterior tumor. This is a bone compression. These acoustic features are very consistent with the histological findings of pleomorphic adenoma. A super is a lesion above the upper part of the iliac crest. The peak of the tumor is higher and the inside is a uniform mid-high wave. The medium attenuation is very similar to the ultrasound characteristics of the cavernous hemangioma.

CT scan

CT scan has an important position in the diagnosis of lacrimal gland epithelial tumors. CT showed that the tumor was located in the lacrimal gland area above the iliac crest, and the tumor showed an expansive growth, a circular or round-shaped high-density block shadow, the boundary was clear and smooth, and the internal density was basically homogeneous. The wall of the lacrimal gland can have pressure changes (bone recess) and lacrimal fossa enlargement. Coronal CT can show sacral bone resorption or bone defect when the lesion is large, but there is little obvious bone destruction which can be distinguished from inflammatory pseudotumor or malignant lymphoma that occurs in the lacrimal gland. The lacrimal gland enlargement is a characteristic change of benign lacrimal gland epithelial tumor, and it is also one of the important indications that distinguish it from other lesions. The anterior boundary of the tumor generally does not exceed the sacral margin, that is, the lesion mainly affects the lacrimal gland of the ankle, and rarely affects the lacrimal gland of the ankle. The recurrent lacrimal gland is benign or flat, which can invade the soft tissue around the eyelid (extraocular muscle) , lift the diaphragm) and bones.

MRI

MRI is similar to other orbital benign tumors in the diagnosis of benign pleomorphic adenoma. T1WI is a medium signal and T2WI is a high signal, but some tumors have a low T2WI signal and a medium signal. The spatial location of the tumor is more clearly understood by scanning multiple angles. The scan shows a significant enhancement of the tumor. Recurrent tumors are irregularly shaped or nodular and can also spread into the brain.

Mixed tumor diagnosis

Differential diagnosis:

The disease should be distinguished from parotid malignant tumors, adenolymphomas, monomorphic adenomas, simple cysts and epidermoid cysts. Mixed tumors are mostly benign, but in order to avoid metastasis and metastasis, surgical treatment is required. The pathology of needle aspiration can be used to determine the benign and malignant before surgery, and rapid frozen examination can be used to distinguish between benign and malignant.

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