SUCCESSFUL TREATMENT OF A HYPOPHARYNGEAL LYMPHOEPITHELIAL CARCINOMA (LEC) PATIENT - A CASE REPORT AND LITERATURE REVIEW

成功治療下咽部之淋巴上皮癌一病例報告與文獻回顧

李唯揚(Wei-Yang Lee) ； 張東浩(Tung-Hao Chang) ； 黃家俊(Chia-Chun Huang) ； 劉幕台(Mu-Tai Liu) ； 畢祖平(Chu-Ping Pi) ； 洪儷中(Li-Chung Hung) ； 周采薇(Tsai-Wei Chou)

《放射治療與腫瘤學》 24卷2期 (2017/06) Pp. 151-159

https://doi.org/10.6316/TRO/201724(2)151

摘要

Introduction: Lymphoepithelial carcinoma (LEC), mostly seen in the nasopharynx, is a rare cancer of the hypopharynx. LEC is characterized by an undifferentiated non-keratinizing squamous cell carcinoma with a significant lymphocytic infiltration, and is histopathologically similar to non-keratinizing, undifferentiated nasopharyngeal carcinomas (NPC), but is less associated with the Epstein-Barr virus (EBV). Case report: In this study, we report the diagnosis and treatment by concurrent chemoradiotherapy (CCRT) of a 71-year-old male hypopharyngeal LEC patient in Aug 2014. The patient completed the CCRT treatment course. In the follow-up image survey half a year after treatment, a partial tumor response was noted. Further, complete regression was achieved in the following image survey 9 months after treatment. Discussion: In this rare case of advanced stage, non-EBV related hypopharyngeal LEC, a good response to definitive CCRT was achieved within the 15-month follow-up period. However, more patients are required to define the optimal treatment for hypopharyngeal LEC.

關鍵字

Hypopharyngeal cancer ； Lymphoepithelial carcinoma ； Concurrent chemo-radiotherapy

並列摘要

前言：下咽部之淋巴上皮癌為一種罕見的癌症，此類癌症的細胞型態多發生於鼻咽部。淋巴上皮癌主要由分化不良型的未角化鱗狀細胞組成，並同時有明顯的淋巴浸潤。在組織病理學和未分化未角化鼻咽癌非常相近。不同的是下咽部之淋巴上皮癌並不像大多數的鼻咽癌一般，與EB病毒有密切的相關性。病例報告：一名71歲的男性，在2014年的8月被診斷出下咽部之淋巴上皮癌，並在之後緊接著接受合併化學及放射線治療。在治療結束四個月後，根據影像學上的追蹤可發現腫瘤達到部分有效；而在九個月後，影像學上的追蹤發現腫瘤達到完全有效。討論：在這個罕見的晚期下咽部之淋巴上皮癌病人身上，主程性合併化學及放射線治療，在到目前為止的十五個月中，追蹤發現有不錯的治療效果。不過仍需要更多的案例才能決定出最適當的治療方式。

並列關鍵字

下咽癌 ； 淋巴上皮癌 ； 合併化學及放射線治療