Wang Rong-guang, Wang Gang, Chen Lei
Department of Otorhinolaryngology Head and Neck Surgery , General Hospital of People's Liberation Army, Beijing, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2011 Aug;46(8):664-8.
Three cases of primary squamous cell carcinoma in the frontal sinus were reported, and the experience obtained from diagnosis, treatment of this rarely seen tumor was presented.
Between August 2006 and January 2010, 3 cases of primary squamous cell carcinoma in the frontal sinus were diagnosed and treated including one case of basaloid squamous carcinoma, one moderately differentiated squamous cell carcinoma and one papillary squamous cell carcinoma. All 3 cases were treated with a combined approach using the endoscope and a frontal craniotomy, followed by radiotherapy and chemotherapy.
Case one developed multiple metastatic carcinoma lesions along the coronal incision inside the hairline. She received radiotherapy and chemotherapy, but died 16 months after surgery. Case 2 was found to have tumor recurrence in the left frontal sinus and orbit 40 days after surgery during his course of radiotherapy. Salvage surgery (orbital exoneration and tumor resection) was performed and radiotherapy and chemotherapy continued. Three months later, he was found to have bone metastasis and died 10 months after the first surgery. The third case developed orbital apex syndrome and loss of vision on the right side immediately after surgery. Fourteen months after surgery and radiotherapy, she was found to have tumor recurrence in the frontal sinus with intracranial invasion. She refused a second surgical procedure and is still alive with tumor 21 months after her operation.
The prognosis for patients with frontal sinus carcinoma remains extremely poor. Early detection and extended surgical resection combined with radiotherapy and chemotherapy are needed to improve the survival rates of patients with frontal sinus carcinoma.
报告3例额窦原发性鳞状细胞癌病例，并介绍从该罕见肿瘤的诊断和治疗中获得的经验。
2006年8月至2010年1月，诊断并治疗了3例额窦原发性鳞状细胞癌，其中包括1例基底样鳞状细胞癌、1例中分化鳞状细胞癌和1例乳头状鳞状细胞癌。所有3例均采用内镜和额部开颅联合手术治疗，术后进行放疗和化疗。
病例1在发际线内冠状切口沿线出现多处转移癌病灶。她接受了放疗和化疗，但术后16个月死亡。病例2在放疗过程中术后40天被发现左额窦和眼眶肿瘤复发。进行了挽救性手术（眼眶内容剜除术和肿瘤切除术），并继续进行放疗和化疗。3个月后，发现他有骨转移，在首次手术后10个月死亡。第3例术后立即出现眶尖综合征和右侧视力丧失。手术和放疗后14个月，发现她额窦肿瘤复发并侵犯颅内。她拒绝再次手术，术后21个月仍带瘤存活。
额窦癌患者的预后仍然极差。需要早期发现并进行扩大手术切除，联合放疗和化疗，以提高额窦癌患者的生存率。
