腮腺肿瘤

诊断

用于诊断腮腺肿瘤的检查和手术包括：

• 体格检查。医务人员会触摸下巴、颈部和咽喉，查看是否有肿块或肿胀。

• 采集组织样本进行检测。活检是一种采集组织样本并进行检测的医疗程序。该程序通常是用针从腮腺采集液体或组织，可能经面部皮肤把针插入腮腺。

  实验室检测可以显示样本中有哪些类型的细胞，并判断它们是否具有癌性。这些信息有助于医务人员了解预后情况，以及哪种治疗方式最适合您。

  针刺活检的结果并不一定准确。有时结果会将恶性肿瘤误报为良性。正因如此，有些医生在手术前不做活检，而是可能在手术过程中采集组织样本进行检测。
• 影像学检查。影像学检查有助于医护团队了解肿瘤的大小和位置。如果您的腮腺肿瘤是癌性，那么影像学检查可以帮助查看是否有癌细胞扩散的迹象。检查可能包括超声波检查、MRI 和 CT 扫描。

治疗

腮腺肿瘤的治疗通常包括通过手术切除肿瘤。如果肿瘤为癌性，您可能需要接受更多治疗，包括放疗和化疗。

手术

用于切除腮腺肿瘤的手术方法包括：

• 切除部分腮腺。对于大多数腮腺肿瘤，外科医生可以切除肿瘤及其周围的部分健康腮腺组织。剩余的腮腺部分可照常工作。
• 切除全部腮腺。切除全部腮腺的外科手术称为腮腺切除术。对于较大的肿瘤、癌性肿瘤和侵袭腮腺更深部分的肿瘤，可能需要这种手术。
• 切除更多组织以切除所有癌变部位。如果腮腺癌已侵入附近的骨骼和肌肉，可能需要随腮腺一同切除这部分。外科医生会尽量切除全部癌变部位及其周边的少量健康组织。然后，他们会努力修复这些区域，使您保留咀嚼、吞咽、说话、呼吸和移动面部的能力。为此，可能需要移植从您身体其他部位取下的皮肤、组织、骨骼或神经。非癌性腮腺肿瘤无需这种手术。

为了接近腮腺，外科医生会在耳朵附近的皮肤做一个切口。切口通常隐藏在皮肤褶皱下或耳后。

有时会在手术过程中取一份肿瘤组织样本进行化验，以确定是否为癌症。病理医生（使用血液和身体组织来诊断疾病的医生）会立即检测样本，然后告诉外科医生是否为癌性肿瘤。这些信息可以帮助外科医生确定要切除腮腺的多大部分。病理医生还可能检测周围淋巴结和其他组织，寻找癌症迹象。

腮腺包围着控制面部肌肉运动的神经。这根神经是面神经。外科医生会格外小心，避免对其造成伤害。他们可能用电子设备进行检查，确保面神经在术后依然保持正常功能。

手术中有时会造成面神经的拉伸。这可能导致面部肌肉活动能力丧失。肌肉活动通常会逐渐得到改善。在极少数情况下，必须切断面神经才能切除整个肿瘤。外科医生可能使用来自您身体其他部位的神经或人工神经来修复面神经。

腮腺肿瘤外科手术可能很复杂。它需要训练有素的外科医生和专科医生相互配合才能获得最佳效果。如果您将接受腮腺肿瘤手术，请在手术前向外科医生咨询相关问题。详细了解手术相关信息可能会让您对治疗计划更加放心。您可以考虑咨询：

• 要进入腮腺，您会在哪里做皮肤切口？我会留疤吗？
• 您打算切除我腮腺的多大部分？
• 伤及面神经的概率有多大？您将如何避免这种情况？
• 您如何确定已切除所有肿瘤？
• 您会切除任何淋巴结吗？
• 我是否需要做重建手术？它的流程是怎样的？
• 恢复期间预计会出现哪些情况？要多久才能痊愈？

放射疗法

放射疗法利用强大的能量束来杀死癌细胞。能量可能来自 X 线和质子等来源。

放射疗法用于治疗腮腺癌。手术后可能会建议进行放射疗法。辐射可以杀死任何残留的癌细胞。如果无法进行手术，放射疗法或许是腮腺癌的一线疗法。

化疗

化疗使用强效药物杀死癌细胞，有时可用于治疗腮腺癌。如果癌症有扩散的风险或者无法选择进行手术，就可能需要这种治疗。在这种情况下，化疗可能与放射疗法并用。

化疗有时单独用于晚期癌症，例如已经扩散到身体其他部位的癌症。化疗可能有助于减轻由癌症引起的疼痛和其他症状。

Targeted therapy

Targeted therapy uses medicines that attack specific chemicals in the cancer cells. By blocking these chemicals, targeted treatments can cause cancer cells to die.

Targeted therapy might be an option for treating parotid gland cancers when other treatments haven't helped.

准备您的预约

Make an appointment with a doctor or other healthcare professional if you have any symptoms that worry you.

If your healthcare professional thinks that you might have a parotid tumor, you may be referred to a doctor who specializes in diseases of the ears, nose and throat. This doctor is called an ENT specialist or an otolaryngologist. If a cancer diagnosis is made, you also may be referred to a doctor who specializes in treating cancer, called an oncologist.

Because appointments can be brief, it's a good idea to be prepared. Here's some information to help you get ready.

What you can do

• Be aware of anything you need to do ahead of time. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet.
• Write down symptoms you have, including any that may not seem related to the reason for which you scheduled the appointment.
• Write down important personal information, including major stresses or recent life changes.
• Make a list of all medicines, vitamins or supplements you're taking and the doses.
• Take a family member or friend along. Sometimes it can be very hard to remember all the information provided during an appointment. Someone who goes with you may remember something that you missed or forgot.
• Write down questions to ask your healthcare team.

Your time with your healthcare team is limited, so preparing a list of questions can help you make the most of your time together. List your questions from most important to least important in case time runs out. For parotid tumors, some basic questions to ask include:

• Do I have a parotid tumor?
• Is my parotid tumor cancerous?
• What is the stage of my parotid tumor?
• Has my parotid tumor spread to other parts of my body?
• Will I need more tests?
• What are the treatment options?
• How much does each treatment increase my chances of a cure or prolong my life?
• What are the potential side effects of each treatment?
• How will each treatment affect my daily life?
• Is there one treatment option you believe is the best?
• What would you recommend to a friend or family member in my situation?
• Should I see a specialist?
• Are there any brochures or other printed material that I can take with me? What websites do you recommend?
• What will determine whether I should plan for a follow-up visit?

Don't hesitate to ask other questions.

What to expect from your doctor

Be prepared to answer questions, such as:

• When did your symptoms begin?
• Have your symptoms been continuous or occasional?
• How severe are your symptoms?
• What, if anything, seems to improve your symptoms?
• What, if anything, appears to worsen your symptoms?