Mao Y J, Luo X M, Zhou S H, Zheng Z J
Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
J Int Med Res. 2010 Mar-Apr;38(2):711-9. doi: 10.1177/147323001003800236.
A case report of laryngeal myoepithelial carcinoma (MEC) is presented and the literature concerning prognostic factors in MEC is reviewed. A 61-year old man was admitted to hospital with hoarseness and progressive dyspnoea. On examination, both vocal cords were fixed in the midline with a glottic fissure of only 3 mm. No tumour was seen, but the subglottis was not completely visible. A computed tomography scan showed a soft mass below the right vocal cord obstructing two-thirds of the larynx. On suspension laryngoscopy, a dull mass (1.5 x 1.5 cm) was seen below the right vocal cord, which was malignant on frozen biopsy. A total laryngectomy was performed and the patient received radiotherapy. He died of recurrence 25 months later. The tumour was positive for cytokeratin 14, S-100 protein and calponin. MEC of the larynx is extremely rare. The clinical behaviour of MEC is variable and prognostic factors have been poorly analysed. Calponin expression may be a prognostic factor, but other factors also affect the outcome in MEC.
本文报告一例喉肌上皮癌（MEC）病例，并对有关MEC预后因素的文献进行综述。一名61岁男性因声音嘶哑和进行性呼吸困难入院。检查发现，双侧声带固定于中线，声门裂仅3mm。未见肿瘤，但声门下区未完全可视。计算机断层扫描显示右侧声带下方有一软组织肿块，阻塞了三分之二的喉部。在支撑喉镜检查中，右侧声带下方可见一质硬肿块（1.5×1.5cm），冰冻活检显示为恶性。行全喉切除术，患者接受放疗。25个月后因复发死亡。肿瘤细胞角蛋白14、S-100蛋白和钙调蛋白呈阳性。喉MEC极为罕见。MEC的临床行为多变，对预后因素的分析较少。钙调蛋白表达可能是一个预后因素，但其他因素也会影响MEC的预后。
