Spindle Cell Carcinoma in Unknown Primary Head and Neck Cancer-Case Report

原發部位不明之頭頸部梭狀細胞癌－病例報告

許淳翔(Chun-Hsiang Hsu) ； 陳俊天(Chun-Tien Chen) ； 趙品植(Pin-Zhir Chao) ； 李飛鵬(Fei-Peng Lee) ； 王興萬(Hsing-Won Wang)

《台灣耳鼻喉頭頸外科雜誌》 55卷1期 (2020/03) Pp. 46-50

https://doi.org/10.6286/jtohns.202003_55(1).046

摘要

Spindle cell carcinoma, as defined by the National Institutes of Health, is also known as sarcomatoid carcinoma. It is a type of cancer that appears to be a mixture of carcinoma and sarcoma. The sarcoma-like cells are often spindle cells. The overlapping effects of both cancers mean that misdiagnosis and mortality rates are high for rare cases. This paper presents a rare case of a 70-year old male with neck mass, which was initially diagnosed as myeloid sarcoma, but later diagnosed as spindle cell carcinoma in unknown primary head and neck cancer. He then received concurrent chemoradiotherapy and eventually expired 6 months after the onset of symptoms. To the authors' best knowledge, this is the first case of spindle cell carcinoma in unknown primary head and neck cancer to be reported in English. So we presented how this rare case was diagnosed and treated, expecting those similar patients in the future could have better management.

關鍵字

head and neck cancer ； sarcomatoid carcinoma ； spindle cell carcinoma

並列摘要

梭狀細胞癌，美國衛生研究院也定義稱為肉瘤樣癌。此癌症為上皮細胞癌及肉瘤之混和型態。此類肉瘤細胞通常為梭狀細胞。也因兩類癌細胞之重疊特性及僅有少數案例，因而誤診及死亡率仍居高不下。此篇案例報告為1名70歲男性，伴隨頸部腫塊，起初診斷骨髓性肉瘤，但最後確診為原發部位不明之頭頸部梭狀細胞癌。之後以同步放射及化學治療，但仍於發現臨床症狀後6個月死亡。就作者目前所知，此為第一篇以英文發表之原發部位不明之頭頸部梭狀細胞癌案例。期盼探討該案例的診斷及治療方式，能讓接下來類似案例有更好的處置。

並列關鍵字

head and neck cancer ； sarcomatoid carcinoma ； spindle cell carcinoma（頭頸癌 ； 肉癌瘤 ； 梭狀細胞癌）