- 期刊
軟腭的類基底鱗狀細胞癌─病例報告
Basaloid Squamous Cell Carcinoma of the Soft Palate - Case Report
摘要
類基底鱗狀細胞癌 (basaloid squamous cell carcinoma) 為鱗狀細胞癌的一種變異，病例很少見，於1986年由Wain等首先確立診斷，至今於英文文獻上只有約90例。類基底鱗狀細胞癌為高度惡性腫瘤，往往早期即有頸部淋巴或全身轉移。因細胞組成上的異質性，小件病理切片常難以正確診斷。患者以老年男性居多，好發於上呼吸消化道，特別是舌根、梨狀窩及聲門上喉部最常見。本院於1996年7月經歷1例罕見的軟腭部位類基底鱗狀細胞癌。患者為79歲女性，主訴數月來右側口腔內反覆疼痛流血。理學檢查發現右側軟腭有一3 x 3cm大小、中央潰瘍向外生長的腫瘤，右頸部有一4 x 4cm大小無痛性硬塊。口腔內腫瘤病理切片顯示為惡性腫瘤。在此之前病人曾於1994年10月在他院門診接受口腔內腫瘤切片檢查，病理報告為小細胞癌。病患住院後經手術切除腫瘤及右側頸部淋巴廓清，最終確定診斷為類基底鱗狀細胞癌。術後病人於他院接受放射治療，於門診追蹤至今，無復發或其他併發症產生。
並列摘要
Basaloid squamous cell carcinoma(BSCC) is a variant of squamous cell carcinoma. Since its first description by Wain et al in 1986, only about 90 cases have been described in the English literature. BSCC is a biologically high-grade tumor with a propensity for nodal as well as systemic metastases. Because of its heterogeneous composition, it is often difficult, or even impossible, to confidently establish a diagnosis of BSCC on small biopsy specimens. The tumor occurs predominantly in men in their 60s and 70s. The lesion has a predilection for the upper aerodigestive tract, especially supraglottis, pyriform sinus, and tongue base. In July 1996, we encountered a case of BSCC that occurred right in the soft palate-an unusual location. The 79-year-old woman presented with a touch-bleeding tumor in the right side of the soft palate for months. Clinical examination revealed a 3 x 3cm exophytic tumor with central ulceration and a 4 x 4cm lump in te right midnceck. An incisional biopsy for intraoral tumor revealed malignant change. Before that time, she had ever received biopsy for oral tumor at other hospital in October 1994. The pathological resultwas small cell carcinoma. After admission, the patient underwent wide excision of the soft palate tumor with right radical neck dissection. The final pathologic diagnosis was basaloid squamous cell carcinoma. After discharge, the patient received radiotherapy at other hospital. No locoregional recurrence or distant metastasis has been found till now.