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耳鼻喉科医师常见到面部疼痛的病人。如果没有典型症状和有关的体征,应想到鼻窦、牙齿疾病,不典型的神经痛、偏头痛或是颅底恶性肿瘤。本文报告一例眼眶的原发性鳞状细胞癌引起面部疼痛。病人女性,53岁,主诉左侧面部疼痛,初诊时仅左颧突部位有局限性触痛。复诊时,除局部仍有触痛外,左颧突有略微饱满的软组织。因疼痛加重,在复诊后2周行颧突部手术探查,发现在外侧眶壁,围绕三义神经分出的额面支出口处,有一约3mm直径的软组织结节,此结节与该神经紧密粘连。在颧骨孔内侧,有一腊肠样肿瘤,延伸于眶的颞下象限全长,终止于眶下裂,眶骨膜无破坏。将肿瘤完整取除。组织病理学检查为二级鳞状细胞癌。由于癌肿切除的边缘不清楚,术后施行放射治疗6周(5600拉德)。7年无复发。视力无损害。眼眶鳞状细胞癌极少见。此类癌有典型的突眼。眼眶转移性鳞状细胞癌,可源于女性生殖器官,支气管,眼眶附近皮肤,后者可有骨质侵蚀。本病例独特
Otolaryngologists often have facial pain patients. Without typical symptoms and associated signs, one should think about sinuses, dental problems, atypical neuropathic pain, migraines or skull base malignancies. This article reports a case of orbital primary squamous cell carcinoma that causes facial pain. A 53-year-old female patient complained of facial pain on the left. Only a limited amount of tenderness was found in the left zygomatic protrusion when first visit. Referral examination, in addition to the local still tenderness, the left zygomatic slightly soft tissue. Due to the aggravation of pain, zygomatic protrusion exploration was performed two weeks after the visit and found that there was a soft tissue nodule about 3 mm in diameter on the lateral orbital wall, at the frontal branch outlet surrounding the trigeminal nerve. This nodule was associated with the nerve Close adhesion. Inside the zygomatic hole, there is a sausage-like tumor that extends the full length of the infratemporal quadrant, ending in the infraorbital fissure, without destruction of the orbital periosteum. Complete removal of the tumor. Histopathological examination for two squamous cell carcinoma. Radiotherapy was performed for 6 weeks (5,600 rad) postoperatively as the margin of the tumor was unclear. No recurrence in 7 years. Vision without damage. Orbital squamous cell carcinoma rare. Such cancer has a typical exophthalmos. Orbital metastatic squamous cell carcinoma, may be derived from the female genital, bronchial, orbital skin, which may have bone erosion. This case is unique