Remick S C, Hafez G R, Carbone P P
Department of Human Oncology, University of Wisconsin Clinical Cancer Center, Madison 53792.
Medicine (Baltimore). 1987 Nov;66(6):457-71.
We report 18 patients with extrapulmonary small-cell carcinoma, which we regard as a distinct clinicopathologic entity. The natural history of this disease in some sites appears to differ from that of small-cell lung cancer. One patient with small-cell carcinoma of the esophagus was treated with combination chemotherapy and survived for 1 year. Another patient had ectopic adrenocorticotropic hormone production with small-cell carcinoma of the rectum. Two patients with small-cell bladder carcinoma are also reported in this series. Another patient with small-cell carcinoma in a cervical lymph node metastasis has survived more than 7 years after receiving radiation as the only modality of therapy. This case further substantiates the observations of others that extrapulmonary small-cell carcinoma may pursue an indolent course. Furthermore, in certain sites, local modalities of therapy may result in long-term survival or cure. This is particularly true for small-cell neoplasms of the head and neck region. An association between smoking and extrapulmonary small-cell carcinoma is postulated. The therapy and outcome of this disease is also discussed, with particular emphasis on the effectiveness of combined strategies of surgery, radiation, and chemotherapy.
我们报告了18例肺外小细胞癌患者，我们将其视为一种独特的临床病理实体。该疾病在某些部位的自然史似乎与小细胞肺癌不同。一名食管小细胞癌患者接受联合化疗后存活了1年。另一名患者直肠小细胞癌伴有异位促肾上腺皮质激素分泌。本系列还报告了两名膀胱小细胞癌患者。另一名颈部淋巴结转移小细胞癌患者在接受放疗作为唯一治疗方式后存活超过7年。该病例进一步证实了其他人的观察结果，即肺外小细胞癌可能病程进展缓慢。此外，在某些部位，局部治疗方式可能导致长期存活或治愈。头颈部区域的小细胞肿瘤尤其如此。推测吸烟与肺外小细胞癌之间存在关联。还讨论了该疾病的治疗及预后，特别强调了手术、放疗和化疗联合策略的有效性。
