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Abstracts


食道癌初期的症狀並不明顯,主要是吞嚥困難或體重減輕。一47歲男性病患,突發左側聲帶麻痺2星期,當時胸部X光並無異常發現;5個月後才開始吞嚥困難,胸部X光及電腦斷層呈現上縱膈腔的病灶,上消化道內視鏡檢顯示食道中段處的腫瘤,組織病理報告為腺癌,腹部超音波顯示疑似右側腎上腺轉移,最後診斷為T4N0M1,第IV期食道癌,建議化學放射合併治療;不料,2週後突然大量吐血休克後死亡。因此,建議聲帶麻痺患者,就算是病史回顧、理學檢查及胸部X光均無異樣者,尚需考慮安排頭頸胸的電腦斷層及上消化道內視鏡檢,特別是對於抽菸酗酒者,或無明顯病因卻未自行恢復者。特報告該病例,除了罕見外,亦為警惕。

Parallel abstracts


The early presentat ion of esophageal malignancy is always negligible, predominately dysphagia or body weight loss. A 47-year-old male patient presented with sudden left vocal palsy for 2 weeks. Chest X-ray (CXR) revealed normal. After 5 months, dysphagia began to bother him, and CXR and computed tomography (CT) revealed an obvious mass lesion in the superior mediastinum; upper gastrointestino-scopy (UGI scopy) showed a tumor in the middle esophagus, and pathologic study reported adenocarcinoma; abdomen ultra-sonography showed a suspected metastasis in the right adrenal gland; therefore, the esophageal malignancy was staged T4N0M0, stage Ⅳ. He was scheduled for concurrent chemotherapy/radiotherapy; however 2 weeks later, he died of massive hematemesis. In conclusion, head-neck-chest contrasted CT and UGI scopy are recommended for vocal palsy despite of delicate history-review, normal physical examinations and normal CXR, especially for a cigarette smoker or alcohol drinker, or un-recovery without a significant cause. Herein we present the rare case as a warning.

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