Liu Ye-hai, Li Hong-wu, Zhao Yi, Yang Ke-lin, Wu Jing, Lu Di-hong, Li Yi-fan
Department of Otorhinolaryngology, Anhui Medical University, Hefei, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2011 Dec;46(12):1005-8.
To study the diagnosis and treatment of the malignant tumor involving carotid artery.
A total of 23 cases of recurrent malignant tumors involving the carotid artery were included in this study. For the primary cancers, 8 of 23 cases were laryngeal carcinomas, 10 hypopharyngeal carcinomas, 2 thyroid carcinomas, 1 tonsil carcinoma, 1 parotid gland carcinoma, and 1 hypopharyngeal sarcoma with the invasion of cervical esophagus. Detailed evaluation on each case was performed before treatment. The relations of recurrent tumors with neck blood vessels were determined with enhanced CT/CTA. Of 23 cases with recurrent malignant tumors involving the carotid artery, 16 cases received surgery and 7 cases received the palliative treatment without operation.
Seven patients with palliative treatments died of hemorrhage from the invaded neck blood vessels, systemic failure or pulmonary metastasis in six months. Of 16 cases with surgery, recurrent tumors were completely excised in 14 cases and there were residual tumor tissues on artery walls in 2 cases. Within 16 surgical cases, 2 cases died of neck hemorrhoea after one week because of infection, 2 cases died of lung metastasis 8 months later, 3 cases died of neck local recurrence 1 year later, 2 cases died of lung metastasis after 2 years, 1 case died of neck local recurrence 2 years later and 1 case died of a heart attack 2 years later. The rest 5 cases were alive.
Enhancement CT/CTA can used in the evaluation for recurrent malignant tumors involving the carotid artery. Surgical treatments can be applied to some selected patients, which can improve the quality of life and survival time of the patients.
探讨累及颈动脉恶性肿瘤的诊断与治疗。
本研究纳入23例复发性累及颈动脉的恶性肿瘤患者。原发癌中，23例患者里8例为喉癌，10例为下咽癌，2例为甲状腺癌，1例为扁桃体癌，1例为腮腺癌，1例为侵犯颈段食管的下咽肉瘤。治疗前对每例患者进行详细评估。通过增强CT/CTA确定复发性肿瘤与颈部血管的关系。23例复发性累及颈动脉的恶性肿瘤患者中，16例接受了手术治疗，7例接受了非手术姑息治疗。
7例接受姑息治疗的患者在6个月内死于颈部血管侵犯出血、全身衰竭或肺转移。16例接受手术治疗的患者中，14例复发性肿瘤被完全切除，2例动脉壁上有残留肿瘤组织。16例手术患者中，2例术后1周因感染死于颈部出血，2例8个月后死于肺转移，3例1年后死于颈部局部复发，2例2年后死于肺转移，1例2年后死于颈部局部复发，1例2年后死于心脏病发作。其余5例存活。
增强CT/CTA可用于评估累及颈动脉的复发性恶性肿瘤。手术治疗可应用于部分选择的患者，可提高患者的生活质量和生存时间。
