額竇之移形上皮細胞癌

移形上皮細胞癌(transitional cell carcinoma)爲額竇罕見癌症之一，其相關文獻亦鮮少記載。本院於2007年6月經歷1名54歲男性病患，主訴左眼視力模糊及左側帶血絲之鼻分泌物已持續2個多月，經電腦斷層掃描檢查發現左側額竇一不均質腫瘤合併左側眼眶內壁及上眼窩之侵犯，隨即接受門診切片檢查，病理報告顯示爲移形上皮細胞癌。病患拒絕根除性手術治療，因此安排同步放射線及化學治療；於接受完整療程後，追蹤檢查顯示腫瘤完全消退，持續追蹤1年10個月無復發；然而於2009年10月追蹤檢查發現腫瘤復發，但病患仍拒絕接受救援性手術，目前僅給予支持性藥物治療。本病例顯示同步放射線及化學治療起初可使腫瘤消退，但仍無法根治鼻竇移形上皮細胞癌，針對治癒此疾病的標準治療方式爲手術腫瘤切除並依病況合併放射線及化學治療。

關鍵字

移形上皮細胞癌；鼻竇

並列摘要

Transitional cell carcinoma (TCC) is an urothelial cancer and very rare in the head and neck region. Cancers of the nasal cavity and paranasal sinuses account for only 3% of head and neck malignancies. Among paranasal sinus carcinomas, primary frontal sinus cancer is an extremely rare malignancy, with an incidence of less than 0.3%. We reported a 54-year-old man who had suffered from left blurred vision and left bloodstained nasal discharge for 2 months on June, 2007. Routine ENT examination revealed blood clots over left middle meatus and exophthalmus. The computerized tomography of head and neck revealed a heterogeneous tumor occupying left frontal sinus, eroding the medial orbital wall and superior orbital cavity. The tissue biopsy revealed transitional cell carcinoma. This patient underwent complete concurrent chemoradiotherapy later because he refused radical resection. Tumor completely regressed after the complete course of concurrent chemoradiation; unfortunately, this patient experienced local recurrence 22 months later. Currently, this patient is still alive with disease. In conclusion, TCC is a rare disease and organ preservation protocol may fail in a long period of follow-up. The multimodality treatment including wide resection of tumor, adjuvant radiotherapy and/or chemotherapy remains the mainstay of treatment.

並列關鍵字

transitional cell carcinoma ； paranasal sinus

國際替代計量

額竇之移形上皮細胞癌

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