下咽部的小細胞癌

Small Cell Carcinoma of the Hypopharynx

魏大倫(Ta-Lun Wei) ； 游進益(Ching-Yi Yiu) ； 李勃興(Po-Shing Lee)

《台灣耳鼻喉頭頸外科雜誌》 39卷s-2期 (2004/12) Pp. 141-145

https://doi.org/10.6286/2004.39.s-2.141

摘要

小細胞癌(small cell carcinoma)是一種少見但極具侵犯性之分化不良的神經內分泌癌(poorly differentiated neuroendocrine carcinoma)，它常發生在肺部，而在頭頸部非常少見，至於下咽部的病例數，更是寥寥可數。這種腫瘤非常惡性，容易遠處轉移，常發生於有長期抽菸習慣的老年人，目前被接受的治療方式為手術合併放射治療或化學治療；一般認為此腫瘤預後極差，有報告說大約有3/4的病人活不過18個月，而5年的存活率也僅有5%。本院於2001年8月曾經治療過1個下咽部小細胞癌之患者，他是一個菸齡50年的70歲男性，因為吞嚥疼痛及右側頸部腫塊而來就診，經切片檢查結果為未分化癌，於是住院接受全喉切除併部份咽部切除與重建和右側根除式頸部淋巴廓清術(radical neck dissection)手術，手術後病理報告證實為小細胞癌，術後並接受放射治療，追蹤至今2年多，並無復發及遠處轉移的現象。因下咽部小細胞癌之病例實屬罕見，特提出此報告。

關鍵字

小細胞癌 ； 神經內分泌癌 ； 下咽部

並列摘要

Small cell carcinoma is a rare, highly aggressive and invasive poorly-differentiated neuroendocrine carcinoma that is often in the lungs but rarely in the head and neck region. It is even rarer to occur in the hypopharynx. As a highly malignant lesion, it tends to metastasize early and readily. It is a disease commonly seen in older patients with heavy smoking history. Currently, radiotherapy combined with chemotherapy is the acceptable treatment of choice. The prognosis of the tumor is generally considered as very poor, with three-fourths of cases surviving no more than 18 months. The five-year survival rate was only 5% in most studies. The case presentation is a 70 year-old male patient who sought medical attention because of odynophagia and a right neck mass. He had a history of smoking for 50 years. Initial biopsy result was an undifferentiated carcinoma and he received a total laryngectomy combined with partial pharyngectomy and pharyngeal reconstruction and radical neck dissection. The final pathologic diagnosis is small cell carcinoma. He was then given post-operative radiotherapy. More than two years of follow-up shows no recurrence or distant metastases. For the sparsity of small cell carcinoma of the hypopharynx, this case herein is stated.

並列關鍵字

small cell carcinoma ； neuroendocrine carcinoma ； hypopharynx