Khafif R A, Prichep R, Minkowitz S
Department of Surgery, Maimonides Medical Center, Brooklyn, New York.
Head Neck. 1989 Mar-Apr;11(2):153-63. doi: 10.1002/hed.2880110209.
An extensive historical review of branchial cleft cyst carcinoma is undertaken and a critical analysis of all 67 cases reported in the English literature since Martin's landmark report is carried out and tabulated. Forty-one of the 67 cases were definitely ruled out as carcinomas of branchial cysts. Though only eight of the remaining 26 cases satisfied Martin's criterion of 5-year follow-up without evidence of primary carcinoma elsewhere, 14 patients had incontrovertible evidence of branchiogenic carcinoma, evidenced by a branchial cyst with histologic evidence of epithelial dysplasia progressing to squamous cell carcinoma within the cyst wall. Two previously unreported cases are presented. A therapeutic approach including wide local excision, radical neck dissection, and radiotherapy is recommended. A more thorough search for an occult head and neck primary, and a clearer understanding of the histopathology of branchiogenic carcinoma, are suggested as alternate requirements for this diagnosis.
我们对鳃裂囊肿癌进行了广泛的历史回顾，并对自马丁具有里程碑意义的报告以来英文文献中报道的所有67例病例进行了批判性分析并制成表格。67例病例中有41例被明确排除为鳃裂囊肿癌。尽管其余26例病例中只有8例符合马丁的标准，即经过5年随访且无其他部位原发性癌的证据，但有14例患者有确凿的鳃源性癌证据，表现为鳃裂囊肿，其囊壁内有上皮发育异常进展为鳞状细胞癌的组织学证据。本文介绍了2例此前未报道的病例。建议采用包括广泛局部切除、根治性颈清扫和放疗在内的治疗方法。对于这种诊断，建议更彻底地寻找隐匿性头颈部原发性肿瘤，并更清楚地了解鳃源性癌的组织病理学。
