Pein M K, Holzhausen H, Kösling S, Bartel-Friedrich S, Knipping S
Universitätsklinik und Poliklinik für HNO-Heilkunde, Kopf- und Halschirurgie, Universitätsklinikum Halle, Magdeburger Strasse 12, 06112, Halle, Deutschland.
HNO. 2010 Aug;58(8):812-7. doi: 10.1007/s00106-010-2081-2.
With an incidence of over 90%, squamous carcinomas are the most frequent laryngeal malignancies. Laryngeal neuroendocrine tumors appear only in approximately 1%. These are aggressive tumours with a high rate of metastases. To date, no diagnosis or treatment guidelines have been established for this entity.
We describe the case of a 63-year-old man complaining of dysphagia and intermittent hoarseness. Initial laryngoscopy showed a tumour at the laryngeal epiglottic surface. Staging demonstrated an atypical carcinoid tumour with local lymph-node metastasis. At 24 months following revision surgery with safety distance, elective bilateral neck dissection and adjuvant radiotherapy the patient is free of complaints and recurrence.
In atypical carcinoid tumours total resection as well as bilateral neck dissection should be performed, even in cN0 cases. In the presence of cervical lymph node metastases adjuvant radiotherapy is indicated.
鳞状细胞癌是最常见的喉恶性肿瘤,发病率超过90%。喉神经内分泌肿瘤仅占约1%。这些是具有高转移率的侵袭性肿瘤。迄今为止,尚未针对该实体制定诊断或治疗指南。
我们描述了一名63岁男性的病例,该患者主诉吞咽困难和间歇性声音嘶哑。初次喉镜检查显示会厌表面有肿瘤。分期显示为非典型类癌肿瘤伴局部淋巴结转移。在进行了具有安全切缘的翻修手术、择期双侧颈清扫术和辅助放疗24个月后,患者无不适且无复发。
对于非典型类癌肿瘤,即使是cN0病例,也应进行全切除及双侧颈清扫术。存在颈部淋巴结转移时,应进行辅助放疗。