Sahli Mohamed, Hemmaoui Bouchaib, Benariba Fouad
Department of Head and Neck Surgery, Military Hospital Mohammed V, Rabat, Morocco.
Pan Afr Med J. 2017 Mar 30;26:189. doi: 10.11604/pamj.2017.26.189.11507. eCollection 2017.
Laryngeal cancer metastases are relatively rare and mainly affect the lung. The medullary localization remains exceptional. We report the case of a patient followed for operated laryngeal cancer and whose oncologic control revealed a medullary localization. A patient followed for squamous cell carcinoma of the larynx, treated in 2010 by a partial surgery whose endoscopic control at 5 years revealed the presence of right arytenoid edema without suspicious lesions, multiple biopsies were made and which returned negative. A month later, the patient presented a rebel cervical spine pain and a feeling of heaviness of the upper limbs, for which a radiological assessment was done finally objectifying a right hypopharyngeal process and a suspicious right internal jugular lymphadenopathy (biopsy confirmed the squamous type), as well as an intramedullary metastasis. This case is an illustration of an exceptional evolution of this type of cancer and a are metastatic localization difficult to highlight, which leads us to ask the question on the need of simultaneous and systematic radiological and endoscopic control treatment for operated laryngeal cancer.
喉癌转移相对少见,主要累及肺部。髓内转移极为罕见。我们报告一例接受过喉癌手术的患者,其肿瘤学检查发现存在髓内转移。该患者曾因喉鳞状细胞癌接受治疗,2010年行部分手术,5年后内镜检查显示右侧杓状软骨水肿,无可疑病变,多次活检结果均为阴性。一个月后,患者出现颈部顽固性疼痛及上肢沉重感,最终进行影像学评估发现右侧下咽肿物及可疑的右侧颈内静脉淋巴结肿大(活检证实为鳞状细胞型),还有髓内转移。该病例说明了此类癌症的罕见进展情况以及难以发现的转移部位,这促使我们思考对于接受手术的喉癌患者是否需要同时进行系统的影像学和内镜检查以进行控制治疗。