以鼻塞為表現之鼻咽癌

Nasopharyngeal Carcinoma Presenting with Nasal Obstruction

王聖琮(Sheng-Tsung Wang) ； 林厚鈞(Hou-Chun Lin)

《北市醫學雜誌》 7卷2期 (2010/06) Pp. 167-172

https://doi.org/10.6200/TCMJ.2010.7.2.08

摘要

目的：臨床上診斷鼻咽癌本來就是一項挑戰。本文報告一案例，長期單側鼻塞，多次於診所就醫，後來經診斷為鼻咽癌，並討論造成延遲診斷的可能原因。個案報告：本院於98年一月期間診視一位61歲男性患者，主訴為長期鼻塞及鼻涕倒流，時間長達十年之久，以後鼻鏡檢查發現一表面平滑鼻咽部腫塊，即安排於全身麻醉下將腫瘤摘除，病理化驗結果證實為鼻咽癌。接受放射線治療後，腫瘤消失，一年後追蹤預後良好，無復發及轉移。結論：鼻塞為耳鼻喉科病人常見的症狀之一，尤其當病患又有過敏性鼻炎時，就容易忽略了其他可能的診斷。對於初診及特殊的病患，包含耳、鼻、咽、喉、頭頸部，詳細而徹底的理學檢查確有其重要及必要性。

關鍵字

鼻咽癌 ； 延遲診斷 ； 鼻塞

並列摘要

Objectives: Diagnosis of nasopharyngeal carcinoma is a clinical challenge. Here we present a case with long term nasal obstruction. This patient had visited the LMD several times without adequate diagnosis, and then was diagnosed with nasopharyngeal carcinoma at our hospital. The possible reasons for delay in diagnosis of nasopharyngeal carcinoma are discussed. Case report: A 61 year-old male patient had suffered from long term nasal obstruction and posterior nasal drip for more than ten years. Physical examination by post rhinoscopy showed the presence of a round smooth surfaced nasopharyngeal tumor. Tumor excision under general anesthesia was arranged. The pathology revealed nasopharyngeal carcinoma. The patient received further concomitant radiotherapy and chemotherapy. No recurrence or metastatic disease was found at one year after treatment. Conclusion: Nasal obstruction is one of the most common chief complaints at ENT clinics. This is especially true for allergic rhinitis patients and as a result clinicians might ignore other possible causes of nasal obstruction. A detailed and thorough physical examination, including the whole nasal cavity, nasopharynx, laryngopharynx, head and neck, is indeed important and necessary.

並列關鍵字

Nasopharyngeal carcinoma ； delayed diagnosis ； nasal obstruction