- 期刊
Unusual Presentation of Metastatic Retroperitoneal Lymphadenopathy in Nasopharyngeal Carcinoma
鼻咽癌少見的腹部淋巴腺轉移
摘要
患者罹患鼻咽癌發現遠處轉移的傾向相當高而且預後不佳。常見遠處轉移的位置有骨骼、肺臟、肝臟及遠端淋巴腺。患者一旦發生遠處轉移後，主要的治療方式轉變為緩和性的化學治療。我們經歷一例53 歲男性，原先有腦溢血、高血壓、胃潰瘍的病史，不幸罹患鼻咽癌。患者鼻咽癌且局部侵犯到兩側頸部第二區至第五區淋巴腺及右側鎖骨上方區域。全身骨骼掃瞄發現左肩、胸椎及第11 根肋骨有顯影增加現象，可能是多發性骨轉移。腹部檢查發現在胰臟附近有腫瘤壓迫到肝臟，在電腦斷層導引下執行長針抽吸，病理報告和鼻咽切片相同，屬於未分化細胞癌，癌症分期為IVC期(cT2bN3M1)。患者接受4個療程的化學治療，目前已經存活個月。
並列摘要
Nasopharyngeal carcinoma has a propensity to develop distant metastases with poor prognosis. Metastatic sites usually involves bones, lungs, liver and distant lymph nodes. Management of metastatic disease is essentially palliative and based on chemotherapy. We report a case of a 53-year-old man who had history of old cerebral vascular attack, hypertension and gastric ulcer suffered from nasopharyngeal carcinoma. Bilateral multiple lymphadenopathies from level II to V and right supraclavicular fossa were noted. Bone scan showed bony uptake of radioactivity at the left shoulder joint, thoracic vertebra and left posterior 11th rib. The abdominal examination revealed an intra-abdominal mass around the pancreatic head with external compression to the liver. Aspiration puncture under abdominal computed tomography was performed and pathology revealed undifferentiated carcinoma. The final staging was cT2bN3M1 as stage IVC. The patient was treated with 4 courses of palliative chemotherapy with fluorouracil and cisplatin monthly. He was still alive at 6 months after distant metastases were diagnosed.