Synchronous Multiple Primary Malignant Neoplasms in the Upper Respiratory and Upper Alimentary Tracts-Report of a Case and Review of the Literature

上呼吸道及上消化道同時多發性原發惡性腫瘤－病例報告及文獻溯閱

洪祖祺(Tsu C. Hong) ； 陳光耀(Kuang Y. Chen)

《中華放射線醫學雜誌》 1卷3期 (1976/09) Pp. 165-171

摘要

1975年11月榮民總醫院癌病治療中心檢查一位64歲的男性病人，主訴二個月聲音沙啞及吞咽困難，一連串檢查結果證明此病人同時存在著兩種原發性惡性腫瘤：下咽部的梨形寶癌(carcinoma of the pyriform sinus)及食道癌。兩個原發性癌均接受放射線治療。6個月後複查、治療效果良好。我們溯閱醫學文獻掬發現多發性原發性癌的發生率並不見得低，由0.5%到11%不等，其中約有半數病例屬於「同時」發生。多發性原發性癌較常見於上呼吸道及上消化道，其發生率有報告高達17%者。頭頸部是多發性癌發生最多之處，其他依次為生殖祕尿道、乳房、胸部等。其發生原因尚未確知，但據統計可能與吸煙、喝酒、遺傳、放射線、環境、免疫蛋白缺乏等有關。治療原則與治療兩個不相關聯的原發性腫瘤一樣，但放射線劑量可能略減，因為照射的體積較大。

並列摘要

In November 1975, a 64-year-old male patient, who complained hoarseness of voice and progressive swallowing disturbance for two months. Serial examinations revealed a case of synchronous carcinoma of the pyriform sinus and esophagus. Both cancers were treated by radiation alone. The patient became well 6 months after radiotherapy. We reviewed the literature and found that the incidence of multiple primary malignant neoplasms was not necessary low, ranged from 0.5% to 11%, about half of them occurred synchronously. The occurent rate of multiple primary tumors in the upper respiratory and upper alimentary tracts was reported even higher (17%). The head and neck regions were the most common sites involved by the multiple primary lesions and the less common places were genito-urinary tract, breast, thoracic, etc. The etiology might relate to smoking, drinking, hereditary, radiation, environment and immunoglobulin deficiency. The treatment policy would be the same as treating two separate independent tumors, but the radiation dose might be compromised because a larger volume is irradiated.