口腔鱗狀上皮細胞癌罕見的表現出胃部轉移：一病例報告

A Case of Buccal Squamous Cell Carcinoma with Gastric Metastasis: An Unusual Presentation

張經緯(Ching-Wei Chang) ； 王蒼恩(Tsang-En Wang) ； 張文熊(Wen-Hsiung Chang) ； 施壽全(Shou-Chuan Shih) ； 楊圳隆(Tsen-Long Yang) ； 張義芳(Yi-Fang Chang) ； 鄭旭萌(She-Meng Cheng) ； 陳瑜珍(Yu-Jan Chan)

《中華民國癌症醫學會雜誌》 23卷1期 (2007/03) Pp. 11-17

https://doi.org/10.6588/JCOS.2007.23.1.2

摘要

胃轉移的腫瘤發生率雖低，由於多無症狀，診斷時多已是癌症末期。一般乳房、肺臟及食道為轉移至胃的腫瘤為較常見的原發部位。而以口腔為原發部位的胃部遠端轉移少見。我們報告一位62歲的男性病患有口腔癌的病史，接受過腫瘤切除手術、放射線及化學治療後，無局部復發的現象，並在門診定期追蹤。兩年後，病人因上腹部間歇悶痛有兩個月的時間，被安排腹部超音波檢查，顯示有一巨大腹腔內腫瘤介於胃及胰臟尾部，腹部電腦斷層亦顯示此腫瘤為異質的(heterogenous)且由胃部內側部往外生長，內視鏡亦顯示此腫瘤侵犯至胃上體黏膜並造成潰瘍。病人接受近端胃及食道局部切除手術，病理報告為轉移至胃部的鱗狀上皮細胞癌，正子斷層造影追蹤檢查顯示在氣管、食道及主動脈周邊的淋巴節可能有腫瘤轉移，病人於術後順利出院。本篇亦將針對這罕見病例，討論其臨床表現、可能轉移機轉及相關文獻回顧。

關鍵字

鱗狀上皮細胞癌 ； 胃轉移 ； 口腔癌

並列摘要

The stomach is an unusual site for metastasis. Metastatic gastric tumors may originate from various organs but are most common from breast, lung, and esophageal cancers and melanoma. Gastric metastases from head and neck primary tumors are extremely rare. We present a case of 62-year-old male who had history of squamous cell carcinoma in oral cavity. The patient had upper abdominal pain 2 years after squamous cell carcinoma was diagnosed. Esophagogastroduodenoscopy revealed a protruding tumor with ulceration in the lesser curvature of gastric upper body. On computed tomography, the tumor seemed to have exophytic growth and was heterogenous enhancing in the medial aspect of stomach. It was resected and proved to be metastatic squamous cell carcinoma. Positron emission tomography (PET) also revealed possible tumor metastases to upper paratracheal, lower para-esophageal, and para-aortic lymph nodes. The patient recovered smoothly.

並列關鍵字

Squamous cell carcinoma ； Gastric metastasis ； Buccal cancer