第一鳃裂囊肿伪装为腮腺肿瘤一例报告及文献复习

First Branchial Cleft Cyst Misdiagnosed as Parotid Tumor: A Case Report and Literature Review

摘要: 鳃裂畸形是一类罕见的先天性疾病，多在儿童群体中出现。第一鳃裂囊肿(FBCC)占所有鳃裂畸形的比例不足8%，属于其中较为特殊的一种。依据Work分类法，其可细分为I型和II型。I型常于成年患者身上表现，病变可能出现在腮腺区域，因此可以是腮腺肿胀较为罕见的原因。由于FBCC临床并不常见，对其进行准确的临床识别与合理治疗颇具挑战，极易被误诊为腮腺肿瘤。本文报告了1例起初被误诊为腮腺肿瘤的FBCC病例，该患者腮腺区出现大小为5.0 cm × 3.0 cm的肿物，增强计算机断层扫描(CT)显示为囊实性占位性病变。手术完整切除肿物后，经组织病理学检查确诊为伴有炎症的鳃裂囊肿。因此，外科医生深入掌握FBCC的病因、解剖特点及手术治疗方式，并在术前积极将其纳入鉴别诊断范畴，对降低误诊率至关重要。

Abstract: Branchial cleft anomalies are rare congenital diseases, predominantly observed in children. The first branchial cleft cyst (FBCC), representing less than 8% of all branchial anomalies, is one of them and can be classified by the Work classification into two types: type I and type II. Type I typically presents in adults, with lesion potentially located in the parotid gland region, therefor it can be a rare etiology of parotid gland swelling. Due to its infrequency, the clinical identification and management of the FBCC are significantly challenging and may result in misdiagnosis as parotid tumor. We report a case presenting a unique instance of FBCC initially misdiagnosed as a parotid tumor, exhibiting a 5.0 cm × 3.0 cm mass in the parotid gland region, with enhanced computed tomography (CT) scan revealing a cystic-solid space-occupying lesion. After complete resection, histopathological examination confirmed it was a branchial cleft cyst with associated inflammation. Hence, a thoroughly understanding of the etiology, anatomical features, and surgical management associated with the FBCC, along with a proactive inclusion of this condition in the differential diagnosis prior to surgical procedure, is imperative for surgeons in order to mitigate the incidence of misdiagnosis.