[摘要] 目的 探讨头部皮脂腺癌的诊断与治疗，进一步提高诊治率。方法 收集28例经病理证实的头颈部皮脂腺癌患者的临床资料，其中眼睑皮脂腺癌10例；腮腺皮脂腺癌2例；外耳道皮脂腺癌5例；颌面部皮脂腺癌7例；颈部皮脂腺癌4例，颈部淋巴结转3例，采用手术、放疗、化疗等综合治疗。结果 皮脂腺癌确诊需要免疫组化检测，而罕见的腮腺皮脂腺癌还需和透明细胞癌、黏液表皮样癌和腺泡细胞癌鉴别，全组病例5年以上随访，5年生存率可达71.4%(20/28)，5年内原发灶复发10例，其中，3例伴有区域淋巴结转移而再次手术，4例失访(按死亡计)；2例死于远处转移；2例死于其他疾病。结论 皮脂腺癌多发于头面部尤其是眼睑，罕见的腮腺皮脂腺癌易被临床忽视，主要复发在局部病灶，较少发生淋巴结转移，死亡原因主要为远处转移，早期诊断、早期根治性综合治疗是提高5年生存率的关键。

    [关键词] 皮脂腺癌；头颈部；病理学

    Diagnosis and treatment of sebaceous carcinoma in the Head and Neck (Report of 28 Cases)

    HUANG Jian-nan, ZHAN Shun-tang,ZOU Yuan-bin,et al.

    Department of Otorhinolaryngology- Head and Neck Surgery,Second People's Hospital of Guangdong,Guangzhou，510317，China

    [Abstract] Objective To study the diagnosis and treatment of sebaceous carcinoma in Head and Neck. Methods Collecting 28 cases with sebaceous carcinoma in Head and Neck which was diagnosed with pathology. Of all these patients, the eyelid in 10 cases, parotid in 2cases, external auditory meatus in 5 cases, maxillofacial in 7 cases, neck portion in 4 cases, neck lymph node metastasis in 3 cases. They were treated with surgical operation, radical therapy and chemistry therapy.Results Diagnosis of sebaceous carcinoma demanded immunohistochemistry (IHC), and rare parotid sebaceous carcinoma was still distinguished with clear cell carcinoma, grume epidermis carcinoma and acinic cell carcinoma in pathology. By Follow-up of the all patients over 5 years, survival rate for 5 years was 71.4% (20/28), primary focus recurrence in 10 cases, in which, neck lymph node metastasis was discovered in 3 cases, and one was performed operation once again. Four cases lost communication (count for death); 2cases died of distant metastasis; 2cases died of other diseases.Conclusion The sebaceous carcinoma mostly occurred in Head and neck, especially in eyelid, rare in parotid, which were easily ignored in diagnosis. Recurrence mostly presented in primary focus,and neck lymph node metastasis is much less. The cause of death mainly is distant metastasis. It is key point that forepart diagnosis and treatment can promote survival rate for 5 years. ......