| 摘要: | 目的：本研究在探討亞熱帶地區眼瞼腫瘤之流行病學。重點在眼瞼腫瘤中惡性之比率，臨床診斷之正確性和其手術結果。設計：回溯性病例分析。材料與方法：收集從1994年1月至1998年12月高雄醫學大學眼科眼瞼腫瘤手術之連續病例。結果：共收集了144個連續病例，大約一半位於上眼瞼；一半位於下眼瞼。近50%接受腫瘤切除合併眼瞼重建。至1999年4月之追蹤，97%病人對手術結果滿意。18個病例（12.5%）病理診斷為惡性，包括14例基底細胞癌，3例瞼板腺癌及1例表皮細胞癌。於手術前在惡性腫瘤病例中有2例被臨床診斷為良性腫瘤，有2例被診斷成他種惡性腫瘤。良性腫瘤包括38例痣、15例乳頭狀瘤、13例囊腫、11疣、10例皮脂漏角化症、4例血管瘤和其他腫瘤。所有懷疑惡性之腫瘤在切割時皆以冰凍切片檢查以期達到切除邊緣乾淨。追蹤至研究結束並無腫瘤復發。結論：在一亞熱帶教學醫院眼科之眼瞼手術病例中大約有10%為惡性。因此術者應對眼瞼腫瘤提高警覺，最好是將所有切除之腫瘤送病理檢察。
This retrospective case analysis investigated the epidemiology of eyelid tumors in a subtropical area. The study assessed the proportion of all eyelid tumors that were malignancies, the accuracy of diagnosis, and surgical results. We retrospectively collected all cases of eyelid tumors in the Department of Ophthalmology, Kaohsiung Medical University, Taiwan, between January 1994 and December 1998. Among the 144 cases collected, about half of the tumors were located in the upper eyelids and the other half in the lower eyelids. Nearly 50% of cases underwent tumor resection with eyelid reconstruction. When followed up to April 1999, 97% of patients were satisfied with the surgical results. There were 18 cases (12.5%) of malignant tumors, including 14 basal cell carcinomas, three sebaceous carcinomas, and one squamous cell carcinoma. Before surgery, two malignancies were presumed to be benign tumors while another two were thought to be different malignant tumors. The benign tumors included 38 nevi, 15 squamous papillomas, 13 cysts, 11 verrucae, 10 seborrheic keratoses, four hemangiomas, and others. All tumors that were thought to be malignancies were treated using complete resection with margin monitoring by frozen section. At the end of follow-up, no recurrence was noted. More than 10% of cases of eyelid tumors in this subtropical teaching hospital were malignant. All surgeons should be alert to this phenomenon when they operate on an eyelid tumor. The best policy is to send all specimens for pathologic examination. |
