Ii T, Doutsu Y, Ashitani J, Taniguchi H, Shima T, Sakamoto A, Matsukura S
Third Department of Internal Medicine, Miyazaki Medical College, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1992 Oct;30(10):1884-8.
A 36-year-old man who complained of bloody sputum showed a mass-like shadow in the right upper lung field on chest X-ray, which was diagnosed as adenocarcinoma by sputum cytology in August, 1990. Since his clinical stage was too advanced for curative operation, chemotherapy was started on October 1, 1990. On October 26, he brought up a polyp-like mass, and was found to have polypoid tumors on the bilateral tonsils and nasopharynx, which were biopsied and diagnosed as poorly-differentiated adenocarcinoma. On November 21, CT of the face showed soft tissue density tumors in the bilateral paranasal sinuses. According to the clinical course, all tumors were thought to be metastatic lesions. Since he had suffered from epistaxis and nasal obstruction due to the enlargement of metastatic tumors, nebulization chemotherapy and palliative resection were performed. In February 1991, he developed severe headache due to brain metastasis. Despite irradiation therapy, he died from cerebral intra-tumorous hemorrhage on February 22. We reported a rare incurable case of lung cancer with metastasis to the nasopharynx and paranasal sinuses.
一名36岁主诉痰中带血的男性，胸部X线显示右上肺野有块状阴影，1990年8月经痰细胞学检查诊断为腺癌。由于其临床分期已属晚期，无法进行根治性手术，遂于1990年10月1日开始化疗。10月26日，他咳出一个息肉样肿物，发现双侧扁桃体和鼻咽部有息肉样肿瘤，经活检诊断为低分化腺癌。11月21日，面部CT显示双侧鼻窦有软组织密度肿瘤。根据临床病程，所有肿瘤均被认为是转移灶。由于转移瘤增大导致鼻出血和鼻塞，遂进行雾化化疗和姑息性切除。1991年2月，他因脑转移出现严重头痛。尽管进行了放疗，但仍于2月22日死于脑内肿瘤出血。我们报告了一例罕见的无法治愈的肺癌病例，其转移至鼻咽部和鼻窦。
