原發性鼻腔小細胞神經內分泌癌

Primary Small Cell Neuroendocrine Carcinoma of the Nasal Cavity

吳丕雄(Pi-Hsiung Wu) ； 張國平(Kuo-Ping Chang) ； 朱繡棟(Sau-Tung Chu)

《台灣耳鼻喉頭頸外科雜誌》 40卷5期 (2005/08) Pp. 205-209

https://doi.org/10.6286/2005.40.5.205

摘要

小細胞神經內分泌癌最常發生在肺部，發生在頭頸部者非常少見；就頭頸部來說，較常見發生於喉部。至於鼻腔小細胞神經內分泌癌截至目前英文文獻上約有30餘例的病例報告，好發年齡50歲到70歲，無明顯男女性分布差異。鼻腔小細胞神經內分泌癌常見主訴症狀為流鼻血，臉部疼痛，具侵犯性。治療方式為手術合併放射治療或輔以化學治療。本院於2004年8月經歷1名69歲女性鼻腔小細胞神經內分泌癌病患，主訴左側流鼻血，鼻塞已3個星期。理學檢查發現左側中鼻道上有一紅色腫塊伴隨容易出血且有雙側頸部腫塊，電腦斷層檢查發現疑似左側鼻腔侵犯至上頷竇之腫瘤。磁振造影檢查顯示腫瘤分布於左側中鼻道和下鼻甲後部侵犯至上頜竇及雙側頸部淋巴結轉移。病患於同年9月接受廣泛性鼻腔及鼻竇腫瘤切除與左側根除式頸部淋巴廓清術及右側修正型頸部淋巴廓清術。病理切片檢查證實為鼻腔小細胞神經內分泌癌。術後並接受放射治療，追蹤至今10個月，並無復發及遠處轉移的跡象。

關鍵字

小細胞神經內分泌癌 ； 鼻腔

並列摘要

Small cell neuroendocrine carcinoma is often seen in the lung but rarely in the head and neck region. In the head and neck region, the most common site is the larynx. To date, more than 30 cases of sinonasal small cell neuroendocrine carcinoma have been published in the literature. These tumors often present in patients aged from 50-70 year without sex bias. Epistaxis and facial pain are the most common complaints, and these tumors are aggressive. The treatment modalities of sinonasal small cell neuroendocrine carcinoma include surgery, radiotherapy, and chemotherapy, either alone or in combination. In August 2004, we encountered a case of 69 year-old female who had suffered from left side nasal bleeding and nasal congestion for 3 weeks. On physical examination, a red tumor in the left side middle meatus with touch-bleeding as well as bilateral neck masses were noted. A CT scan revealed that tumor involved the left nasal cavity with extension into the maxillary sinus. MRI revealed that tumor involved the left middle meatus and posterior portion of inferior turbinate with extension into the maxillary sinus together with bilateral neck lymph nodes metastases. She received wide excision of the sinonasal tumor combined with left radical neck dissection and right modified neck dissection in September 2004. The pathology result was nasal small cell neuroendocrine carcinoma. Post-operative radiotherapy was given. There has been no locoregional recurrence or distant metastas is up to the present after 10 months of follow-up.

並列關鍵字

small cell neuroendocrine carcinoma ； nasal cavity