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喉真性癌肉瘤

True carcinosarcoma of the larynx.

作者信息

Zhang M, Zhao L-M, Li X-M, Zhou L, Lin L, Wang S-Y

机构信息

Department of Otolaryngology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, PR China.

出版信息

J Laryngol Otol. 2013 Jan;127(1):100-3. doi: 10.1017/S002221511200285X. Epub 2012 Dec 7.

Abstract

OBJECTIVE

To explore the diagnosis and treatment of carcinosarcoma of the larynx.

METHODS

Clinical information, including presentation, pathology, treatment and outcome, was obtained from a review of patient charts.

RESULTS

Seven male patients were confirmed pathologically to have had carcinosarcoma between 2003 and 2009 in our hospital. All patients underwent surgery: four total laryngectomies, two vertical partial laryngectomies, and one supracricoid partial laryngectomy-cricohyoidopexy. The mean follow up was 40.6 months. At the time of writing, six patients were alive and being followed; two of these suffered regional metastasis to the cervical lymphatic nodes and underwent radical neck dissection. One patient died of multiple distant metastases 60 months post-operatively.

CONCLUSION

Carcinosarcoma of the larynx describes a biphasic tumour showing both carcinomatous and sarcomatous differentiation. It is extraordinarily rare and prone to metastasise to the cervical lymph nodes. Complete surgical resection of laryngeal primary lesions with wide margins and suitable neck dissection of cervical nodes is reasonable therapy.

摘要

目的

探讨喉癌肉瘤的诊断与治疗。

方法

通过查阅患者病历获取临床信息,包括临床表现、病理、治疗及预后。

结果

2003年至2009年期间,我院7例男性患者经病理确诊为癌肉瘤。所有患者均接受了手术:4例行全喉切除术,2例行垂直部分喉切除术,1例行环状软骨上部分喉切除术-环状软骨舌骨固定术。平均随访时间为40.6个月。撰写本文时,6例患者存活并接受随访;其中2例发生颈部淋巴结区域转移,接受了根治性颈清扫术。1例患者术后60个月死于多处远处转移。

结论

喉癌肉瘤是一种具有癌和肉瘤双相分化的肿瘤。极为罕见,且易于转移至颈部淋巴结。对喉原发性病变进行广泛切缘的完整手术切除以及对颈部淋巴结进行合适的颈清扫术是合理的治疗方法。

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