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鼻咽黏液表皮样癌:一例病例报告及文献综述

Nasopharyngeal mucoepidermoid carcinoma: A case report and review of literature.

作者信息

Ollero Javier Martínez, Morón Asunción Hervás, Luis Angel Montero, Sánchez Soraya Marcos, Nazarewsky Andrea Abondano, López Ma José Salgueiro, Aguerri Alfredo Ramos

机构信息

Radiation Oncology Department, Ramón y Cajal University Hospital, Ctra. Colmenar Viejo, Km 9,100, C.P. 28049 Madrid, Spain.

出版信息

Rep Pract Oncol Radiother. 2012 Nov 20;18(2):117-20. doi: 10.1016/j.rpor.2012.10.002. eCollection 2012.

Abstract

BACKGROUND

Salivary gland-type tumors originating in the nasopharynx are rare, and only a few articles about mucoepidermoid carcinomas (MEC) in this location have been reported. We describe one case of nasopharyngeal MEC and, based on a review of the literature, discuss different therapeutic approaches that can be taken regarding the result of histological findings, radiological tests and extent of disease.

CASE PRESENTATION

A 47-year-old woman diagnosed with mucoepidermoid carcinoma of nasopharynx, T1 N3 M0 (stage IV-B) was treated in 2007 with a combination of radiotherapy and chemotherapy to a maximum dose of 70 Gy and concomitant Cisplatin during the radiation. One year later, with the head and neck disease under control, mediastinal nodes relapse appeared which were treated with exclusive radiotherapy to a maximum dose of 65 Gy. One year after the first relapse, a second relapse was detected in the right lung, next to the previously treated mediastinal regions, and the patient initiated a treatment with exclusive chemotherapy based on TPF scheme.

CONCLUSION

For limited or resectable MEC, combined surgery with radiotherapy, or radiochemotherapy, should be considered the main treatment policy. On the other hand, in poorly differentiated, unresectable tumors or nasopharyngeal MEC, radiochemotherapy could be currently the main treatment approach.

摘要

背景

起源于鼻咽部的涎腺型肿瘤较为罕见,关于该部位黏液表皮样癌(MEC)的报道仅有少数几篇。我们描述了一例鼻咽部黏液表皮样癌病例,并基于文献回顾,讨论了根据组织学检查结果、放射学检查及疾病范围可采取的不同治疗方法。

病例介绍

一名47岁女性被诊断为鼻咽部黏液表皮样癌,T1 N3 M0(IV - B期),于2007年接受放疗和化疗联合治疗,放疗最大剂量达70 Gy,放疗期间同步使用顺铂。一年后,头颈部疾病得到控制,但出现纵隔淋巴结复发,遂对其进行单纯放疗,最大剂量为65 Gy。首次复发一年后,在先前治疗过的纵隔区域旁的右肺检测到第二次复发,患者开始接受基于TPF方案的单纯化疗。

结论

对于局限性或可切除的黏液表皮样癌,手术联合放疗或放化疗应被视为主要治疗策略。另一方面,对于低分化、不可切除的肿瘤或鼻咽部黏液表皮样癌,目前放化疗可能是主要治疗方法。

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本文引用的文献

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Different therapeutic strategies in primary salivary gland-type nasopharyngeal carcinomas.
Curr Opin Otolaryngol Head Neck Surg. 2011 Apr;19(2):87-91. doi: 10.1097/MOO.0b013e3283448402.
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