- 期刊
牙齦癌合併兩側頸部多發淋巴結轉移－病例報告及文獻回顧
Gingival Squamous Cell Carcinoma with Bilateral Multiple Lymph Node Metastasis-A Case Report and Review of the Literature
摘要
發生在牙齦部位之口腔癌雖很常見，但發生於沒有菸、酒、檳鄉習慣之婦女，則較爲少見。牙齦癌若合併有多顆頭部林巴結轉移及結外侵犯現象時，即使經過正規之治療，長期存活之病例仍屬少數。本文將提出一例發生於無菸、酒與檳鄉習慣婦女罹患細胞分化不良的下顎牙齦癌病例，臨床分期爲T(下標 4a)N(下標 2b)M0。患者在接受手術治療後，發現同側及後側頭部有高達21顆林巴結轉移，同時多顆淋巴結具有結外侵犯現象，一年後亦在對側頭部發現有二顆淋巴結之轉移。患者在手術後接受合併放射及化學治療，經八年多之追蹤後，目前仍存活，無任何復發之跡象。由於如此多顆淋巴結轉移之病例較爲罕見，且在過去的文獻報告中，這些患者很少存活超過3年，故提出此罕見病例報告，並進一步討論影響其頭部轉移及存活之可能相關因素。
並列摘要
The development of bilateral multiple lymph node metastases from oral squamous cell carcinoma is an uncommon event. A review of the literature reveals that prognosis of this aggressive malignant neoplasm is poor. We present a long-survival (8 years) case with bilateral multiple lymph node metastases from lower gingival carcinoma after surgery and concurrent chemoradiotherapy. A 63-year-old woman underwent an operation for lower left posterior gingival squamous cell carcinoma (cT(subscript 4a)N(subscript 2b)M0) with left multiple (21) neck lymph node metastases. Five months after the initial treatment, right neck lymph node metastases lesion was found, the operation was performed again. Furthermore, the patient was treated by adjuvant CCRT therapy (primary site: 6400 cGy, neck: 5000 cGy) with 5-FU 630 mg/week and cisplatin 60 mg/week for 2 weeks followed by 5-FU 630 mg/week for 24 weeks. Since then, there is no evidence of tumor recurrence and lymph node metastases for more than eight years. In addition, we provided a review of the current literature regarding patient survival with lymph node metastasis from gingival carcinoma.