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患者男性,70岁,因左下磨牙区隆起核桃大小无痛性肿物,刷牙时易出血于1994年7月来我院诊治.患者1992年4月曾在外院行直肠癌根治术.检查发现左侧磨牙远端至磨牙后壁有一3.5cm×3cm大小肿物,表面呈菜花状,舌侧呈球状,与颊侧和舌侧口底无粘连,颈部未触及肿大淋巴结.行肿物病理学检查,示肉芽样组织,内见不规则乳头状腺样组织结构,异型明显,病理诊断:左下颌磨牙区转移性滤泡状腺癌.住院后行X线胸片和腹部B超检查,发现左上肺野内有一3.5cm×3.5cm结节状阴影,左肺门上提,B超还提示右肝内有一4.4cm×4.7cm稍强不均质回声团块,边缘欠规
The patient was a 70-year-old man with a painless mass of walnuts in the left lower molar area. His brushing occurred in July 1994 when he came to our hospital. The patient had undergone radical resection of the rectal cancer in April 1992. A 3.5cm × 3cm tumor was located from the distal side of the molars to the posterior molar wall. The surface was cauliflower-like, and the tongue was spherical. No adhesion was observed with the buccal and lingual floor. The neck was not touched with enlarged lymph nodes. A necropsy examination showed granulose-like tissue with irregular papillary adenoid structure and obvious heterotypic pattern. Pathological diagnosis: metastatic follicular adenocarcinoma in the left mandibular molar area. X-ray and abdominal B-ultrasound were performed after hospitalization. A 3.5cm × 3.5cm nodular shadow was found in the upper left lung field. The left hilar was raised. B-mode ultrasound also showed a 4.4cm × 4.7cm slightly inhomogenous echo mass in the right liver.