Liao Yu-Chang, Adel Mohamad, Lee Li-Yu, Chang Kai-Ping
Department of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital, Kwei-Shan, Tao-Yuan, Taiwan.
Department of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital, Kwei-Shan, Tao-Yuan, Taiwan; Division of Surgical Oncology-Department of Surgery, Al-Azhar University Hospitals, Al-Azhar Faculty of Medicine, Cairo, Egypt.
Auris Nasus Larynx. 2018 Apr;45(2):328-331. doi: 10.1016/j.anl.2017.03.021. Epub 2017 Apr 14.
Cancers found in the resected branchial cleft cyst are rare clinically but usually impose substantive diagnostic and treatment challenges for clinicians.
A 31-year-old man presented with a lateral neck mass that was suspected to be an inflammatory branchial cleft cyst. After excision, the pathologic specimen revealed a benign cystic appearance with a focus of undifferentiated carcinoma. Serologic tests for Epstein-Barr virus were negative. A positron emission tomography scan and upper aerodigestive tract endoscopies were negative for any other suspicious lesion.
The patient underwent random biopsies of the nasopharynx, tongue base, and hypopharynx and bil tonsillectomy. Pathologic examination of the nasopharyngeal biopsies showed the presence of undifferentiated carcinoma. The cancerous part of the branchial cleft cyst and this nasopharyngeal specimen were positive for the latent membrane protein-1 and EBV-encoded RNAs of Epstein-Barr virus (EBV) and confirmed our diagnosis.
This is the first report of a NPC metastasizing to a branchial cleft cyst. Molecular diagnostic techniques facilitate the definite diagnosis that enabled us to refine treatment plans and offered the patient a favorable outcome.
在切除的鳃裂囊肿中发现的癌症在临床上较为罕见，但通常给临床医生带来实质性的诊断和治疗挑战。
一名31岁男性出现颈部外侧肿块，怀疑是炎性鳃裂囊肿。切除后，病理标本显示为良性囊性外观，伴有未分化癌灶。爱泼斯坦-巴尔病毒的血清学检测为阴性。正电子发射断层扫描和上呼吸道消化道内镜检查未发现其他可疑病变。
患者接受了鼻咽、舌根、下咽的随机活检以及双侧扁桃体切除术。鼻咽活检的病理检查显示存在未分化癌。鳃裂囊肿的癌性部分和该鼻咽标本的爱泼斯坦-巴尔病毒（EBV）潜伏膜蛋白-1和EBV编码RNA呈阳性，证实了我们的诊断。
这是鼻咽癌转移至鳃裂囊肿的首例报告。分子诊断技术有助于明确诊断，使我们能够优化治疗方案并为患者带来良好预后。
