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Solitary Extramedullary Plasmacytoma of the Head and Neck: Treatment Outcome in 6 Patients and a Review of Literature

六例頭頸部髓外漿細胞瘤的治療結果與文獻回顧

摘要


目的:頭頸部的骨髓外漿細胞瘤是一種很少見的疾病。本篇回顧了在我們醫院罹患此疾病患者的治療以及預後。方法與材料:六名患者(四名男性與兩名女性)在西元1980年與2010年間於本院被診斷為頭頸部髓外漿細胞瘤。患者們的中位診斷年齡為64歲(範圍為54到79歲)。其中有兩名患者只接受手術治療;兩名只接受放射線治療;另外兩名則接受了手術以及術後的輔助放射線治療。放射線治療的總劑量都在50 Gy上下。結果:所有患者的中位追蹤時間為5年。腫瘤原發部位為鼻腔(2名)、鼻竇(2名)、口咽(1名)以及鼻咽(1名)。兩名只接受手術治療的患者後來都出現局部復發的現象,其中一名在經過第二次手術後就得到了控制。有兩名患者接受手術與放射線治療。另外兩名只接受放射線治療的患者之後都沒有局部復發的現象,但是分別於皮膚以及其他骨骼部位出現了遠端轉移疾病。在追蹤期間沒有患者進展成多發性骨髓瘤。所有接受放射線治療的患者都沒有明顯且嚴重的後遺症。這六名患者中有一名因為此疾病而死亡。結論:四名罹患頭頸部髓外漿細胞瘤的患者在接受單獨或輔助的放射線治療後在局部都得到了良好的控制,但是其中兩名患者之後出現了遠端轉移的病灶。根據這些個案與文獻回顧的結果,放射線治療對於頭頸部髓外漿細胞瘤可為安全且有效的治療方式。

並列摘要


Purpose: Solitary extramedullary plasmacytoma of the head and neck (EMPHN) is a rare disease. The objective of this study was to review the treatment results of EMPHN patients in a single institution in TaiwanMethods and Materials: The cases of 6 patients (4 males and 2 females) diagnosed at our hospital with EMPHN between 1980 and 2010 were reviewed. The median age of the patients was 64 years (range, 54-79 years). Two patients underwent surgery alone, 2 patients underwent radiotherapy alone, and 2 patients underwent surgery and adjuvant radiotherapy. The dose of radiotherapy was 50-50.4 grays (Gy) in 25-28 fractions.Results: The median follow-up duration was 5 years. The primary tumor sites were the nasal cavity (2), paranasal sinuses (2), oropharynx (1), and nasopharynx (1). Local recurrence was observed in 2 patients who underwent surgery alone and local control was achieved in 1 after salvage surgery (no evidence of disease after salvage surgery in the follow up 3 years period). Local control was achieved in 2 patients treated with surgery and adjuvant radiotherapy. Distant metastasis to the skin and bone without evidence of local recurrence was observed in 2 patients treated with radiotherapy alone. None of the patients progressed to multiple myeloma during follow-up evaluations and no severe radiotherapy-related morbidity was observed. One patient who treated with surgery alone died from recurrent EMPHN within the follow-up duration.Conclusions: Local control of the tumor in the primary site was achieved in 4 patients with EMPHN who underwent radiotherapy alone or adjuvant, although 2 of these patients presented with distant metastasis. According to the review of literature and our results, radiotherapy might be safe and effective for local control of EMPHN.

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