Violet Wilmot Victoria, Nixon Iain James, Nixon Ioanna Fragkandrea
Department of ENT, NHS Lothian, Edinburgh, UK.
Edinburgh University, Edinburgh, UK.
BMJ Case Rep. 2016 Aug 9;2016:bcr2016216370. doi: 10.1136/bcr-2016-216370.
Juvenile laryngeal papillomatosis is the commonest cause of benign epithelial tumours of the larynx. Following diagnostic biopsy, surgical debulking is the mainstay of therapy. The condition is often recurrent with further papillomas forming after debridement, requiring serial procedures and occasionally demanding tracheostomy. Rarely, the disease can undergo malignant transformation; most commonly to squamous cell carcinoma. We describe the first reported case of small cell neuroendocrine carcinoma occurring in the previous tracheostomy site of a 29-year-old male with a history of juvenile laryngeal papillomatosis. The patient, with a background of multiple treatments for juvenile papillomas, presented with voice change, breathing difficultly and erythema at the site of previous tracheostomy. Induction chemotherapy followed by chemoradiation was used to treat the lesion with a good response to initial therapy.
青少年喉乳头状瘤病是喉部良性上皮性肿瘤最常见的病因。诊断性活检后,手术减瘤是主要的治疗方法。该病常复发,清创后会形成更多乳头状瘤,需要多次手术,有时还需要气管切开术。该病很少会发生恶变,最常见的是恶变为鳞状细胞癌。我们报告了首例发生在一名29岁有青少年喉乳头状瘤病史男性患者既往气管切开部位的小细胞神经内分泌癌病例。该患者有多次青少年乳头状瘤治疗史,出现声音改变、呼吸困难以及既往气管切开部位的红斑。采用诱导化疗后进行放化疗来治疗该病变,初始治疗反应良好。