Lucas Zarah, Mukherjee Akash, Chia Stanley, Veytsman Irina
Division of Hematology and Oncology, Washington Cancer Institute, Washington, DC 20010, USA ; MedStar Washington Hospital Center, 110 Irving Street, Washington, DC 20010, USA.
MedStar Washington Hospital Center, 110 Irving Street, Washington, DC 20010, USA ; Department of Otolaryngology, MedStar Georgetown University Hospital, Washington, DC 20007, USA.
Case Rep Oncol Med. 2014;2014:424568. doi: 10.1155/2014/424568. Epub 2014 Dec 14.
Importance. Laryngeal cancer infrequently results in distant metastases, but metastasis to skeletal muscle is extremely uncommon. Observations. A 55-year-old male presenting with progressive dyspnea and hoarseness was found to have Stage IVA T4aN2cM0 laryngeal cancer and eventually underwent total laryngectomy. Before the patient could be started on adjuvant chemoradiation, the patient developed masses on both thighs. Biopsy revealed metastatic squamous cell carcinoma consistent with the primary laryngeal cancer. He was offered palliative chemotherapy; however, he developed new soft tissue masses to the left of his stoma and in the prevertebral area one week later. He also had new cervical and supraclavicular nodes and a pathological compression fracture of L3. Patient died within 4 months of diagnosis. Conclusions. Distant metastasis such as skeletal metastasis portends a poor prognosis. Further studies are required to determine the best course of treatment in these patients.
重要性。喉癌很少发生远处转移，但转移至骨骼肌极为罕见。病例观察。一名55岁男性，因进行性呼吸困难和声音嘶哑就诊，被诊断为IVA期T4aN2cM0喉癌，最终接受了全喉切除术。在患者开始辅助放化疗之前，双侧大腿出现肿块。活检显示为转移性鳞状细胞癌，与原发性喉癌相符。给予姑息性化疗；然而，一周后，他在造口左侧和椎前区域出现了新的软组织肿块。他还出现了新的颈部和锁骨上淋巴结以及L3病理性压缩骨折。患者在诊断后4个月内死亡。结论。远处转移如骨转移预示着预后不良。需要进一步研究以确定这些患者的最佳治疗方案。
