McGuirt W F
Department of Otolaryngology, Wake Forest University Medical Center.
Oncology (Williston Park). 1990 Aug;4(8):85-92, 97; discussion 97-8.
The author presents an algorithmic approach to the diagnosis and treatment of neck masses and reviews individual neck mass entities. He stresses that, until proven otherwise, every adult neck mass should be treated as if it were malignant, and, prior to biopsy, should be worked up appropriately with head and neck exams and endoscopic evaluations in search of the primary tumor. This is important because there can be adverse effects to early, inappropriate biopsy--local wound complications, increased local recurrence, and increased distant metastases. In children, an initial biopsy of the mass after a complete physical examination is acceptable because the incidence of primary mucosal cancers in the pediatric age group is low. The role of panendoscopy for neck masses with a known primary mucosal carcinoma is reviewed in light of the high incidence of two simultaneous head and neck primaries. The technique, role, and timing of needle biopsy of neck masses is also discussed.
作者介绍了一种颈部肿块诊断和治疗的算法方法，并回顾了各个颈部肿块实体。他强调，在未得到其他证明之前，每个成人颈部肿块都应被视为恶性肿瘤，在活检前，应通过头颈部检查和内镜评估进行适当检查，以寻找原发肿瘤。这很重要，因为早期不适当的活检可能会产生不良影响——局部伤口并发症、局部复发增加和远处转移增加。在儿童中，在进行全面体格检查后对肿块进行初次活检是可以接受的，因为儿科年龄组中原发性黏膜癌的发生率较低。鉴于头颈部同时出现两个原发性肿瘤的高发生率，对已知原发性黏膜癌的颈部肿块进行全内镜检查的作用进行了回顾。还讨论了颈部肿块针吸活检的技术、作用和时机。
