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喉外周原始神经外胚层肿瘤:一例报告及文献复习

A peripheral primitive neuroectodermal tumor in the larynx: A case report and literature review.

作者信息

Ijichi Kei, Tsuzuki Toyonori, Adachi Makoto, Murakami Shingo

机构信息

Department of Otolaryngology - Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi 467-8601, Japan.

Department of Pathology, Nagoya Daini Red Cross Hospital, Nagoya, Aichi 466-8650, Japan.

出版信息

Oncol Lett. 2016 Feb;11(2):1120-1124. doi: 10.3892/ol.2015.4013. Epub 2015 Dec 9.

Abstract

Primitive neuroectodermal tumors (PNETs) are malignant tumors comprised of small round cells of neuroectodermal origin. Current evidence indicates that peripheral PNETs (pPNETs), which arise in the non-central nervous system, possess histological similarity to Ewing's sarcoma. Though the occurrence of pPNETs in the head and neck region is rare, these are aggressive malignant tumors, and long-term survival rates following diagnosis remain poor. The current report presents a case of pPNET and evaluates its significance with regard to previous studies. In the present case, a tumor was located in the larynx of the patient, and was diagnosed as pPNET. Immunohistochemical analysis indicated that tumor cells were positive for cluster of differentiation 99. The patient was treated with surgery, multiagent chemotherapy and radiotherapy. Five years subsequent to treatment, the patient had survived and demonstrated no evidence of disease recurrence. In existing literature concerning pPNET located outside the head and neck region, it is recommended that patients are treated with a combination of resection with a wide surgical margin, multiagent chemotherapy and radiotherapy. The present case report concluded that the combination of surgery, systematic chemotherapy and radiotherapy, offers an improved outcome for pPNET localized to the head and neck region, compared with any of these therapies alone.

摘要

原始神经外胚层肿瘤(PNETs)是由神经外胚层起源的小圆细胞组成的恶性肿瘤。目前的证据表明,发生在非中枢神经系统的外周PNETs(pPNETs)在组织学上与尤因肉瘤相似。尽管头颈部区域发生pPNETs的情况罕见,但这些是侵袭性恶性肿瘤,诊断后的长期生存率仍然很低。本报告介绍了一例pPNET病例,并根据以往的研究评估其意义。在本病例中,肿瘤位于患者的喉部,被诊断为pPNET。免疫组织化学分析表明肿瘤细胞分化簇99呈阳性。患者接受了手术、多药化疗和放疗。治疗五年后,患者存活且无疾病复发迹象。在关于头颈部以外区域pPNET的现有文献中,建议对患者采用广泛手术切缘切除、多药化疗和放疗相结合的治疗方法。本病例报告得出结论,与单独使用这些疗法中的任何一种相比,手术、全身化疗和放疗相结合对头颈部局限性pPNET的治疗效果更佳。

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