下咽癌之多處頭皮轉移

Multiple Scalp Metastasis from Hypopharyngeal Carcinoma

康仲然(Chung-Jan Kang) ； 陳聰明(Tsung-Ming Chen) ； 廖俊達(Chun-Ta Liao) ； 王宏銘(Hung-Ming Wang)

《台灣耳鼻喉頭頸外科雜誌》 38卷s_1期 (2003/01) Pp. 38-41

https://doi.org/10.6286/2003.38.s_1.38

摘要

頭頸部惡性腫瘤中，下咽癌約佔8~10%。因其早期症狀不明顯，診斷時大都較晚期，故其遠處轉移率較其他頭頸部惡性腫瘤為高。遠處轉移以肺臟、肝臟及骨骼較常見，而皮膚轉移中以頸部皮膚轉移最多。本院經歷一個病例，患者為53歲男性，主訴聲音嘶啞3個月伴隨右側頸部腫塊，下咽部病理切片報告為鱗狀上皮細胞癌，臨床診斷為下咽癌，臨床分期為T4N2bM0。病患接受全喉及下咽部切除併兩側頸部淋巴廓清術，術後並接受同步放射線及化學治療。術後10個月，門診追蹤發現患者頭皮多處囊腫，經行超音波細針吸引後，細胞學檢查為轉移性鱗狀上皮細胞癌；病患再接受支持性化學治療，後仍因敗血症死亡。下咽癌轉移至頭皮，病例尚屬少見，特提出報告。

關鍵字

下咽癌 ； 遠處轉移 ； 頭皮

並列摘要

Malignant neoplasms of the hypopharynx account for approximately 8% to 10% of all head and neck cancers. Hypopharyngeal carcinoma has a relatively higher distant metastasis rate due to late presentation and a more advanced stage. Among the head and neck cancers that have cutaneous metastasis, the skin of the neck has the most frequent rate. To the English literatures that have been published, there are no related report of scalp metastasis from Hypopharyngeal carcinoma. We reported a 53 year-old man with complaints of hoarseness and right neck mass for 3 months. On the transnasal fibroptic examination, a bulging mass from the right pyriform sinus was found, and right vocal cord paralysis was noted. An incisional biopsy was exerted in the operation room under general anesthesia, and squamous cell carcinoma was reported. Total hypophary-ngolaryngectomy with bilateral neck dissection was performed. Furthermore, he received postoperative adjuvant concurrent chemoradiotherapy. Ten months after surgery, multiple nodule-like lesions were found in the scalp. The lesions showed intact skin with the appearance of hair loss. Needle aspiration revealed metastatic squamous cell carcinoma. He received palliative chemotherapy for the distant metastasis to the scalp. He died of sepsis 6 months later.

並列關鍵字

hypopharyngeal careinoma ； distant metastasis ； scalp