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鼻腔鼻竇小細胞神經內分泌癌-五例報告

Sinonasal Small Cell Neuroendocrine Carcinoma-Report of Five Cases

摘要


鼻小細胞神經內分泌癌(sinonasal small cell neuroendocrine carcinoma)在鼻腔及鼻竇區域的惡性腫瘤中相當罕見,近年來的文獻均視為極具侵襲性且易遠處轉移,預後較一般上皮細胞癌為差的惡性腫瘤。我們提出成大醫院從1991~2005年所經歷的5個病例,其中除1例外,其餘4例均以手術治療後,再輔以術後的同步化學及放射線合併治療或術後的放射線治療。此5例其中1例在接受治療後追蹤至9年4個月發生局部復發的情形,另外4例在接受治療後一年內即發生局部復發或遠處轉移的情況,我們就這5病例臨床表現加以分析及說明。

並列摘要


Small cell neuroendocrine carcinoma of the sinonasal tract is a rare disease. Five cases of sinonasal small cell neuroendocrine carcinoma were treated between 1991 and 2005 in National Cheng Kung University Hospital. Three of the patients were male and two were female, with a mean age at presentation of 54 years (range: 21 to 77 years). Surgery was the primary treatment except one patient. After surgery, two patients received post-operative concurrent chemoradiotherapy and the others received postoperative radiotherapy. Loco-regional recurrence or distant metastasis occurred in 4 cases during one year after treatment. One patient was alive with a local recurrence at a follow-up period of 112 months after combined modality treatment. Sinonasal small cell carcinoma is an uncommon neoplasm with aggressive clinical behavior. Recurrence is frequent and the prognosis is poor. Combined chemotherapy, radiotherapy and surgery is advocated.

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