Sato Hiroki, Yoshimasu Shoko, Okamoto Isaku, Shimizu Akira, Katsube Yasuaki, Tanaka Hideki, Tsukahara Kiyoaki
Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan.
Case Rep Otolaryngol. 2018 Jul 31;2018:1463218. doi: 10.1155/2018/1463218. eCollection 2018.
We report a rare case of hypopharyngeal squamous cell carcinoma occurring synchronously with extramedullary plasmacytoma (EPM) of the oropharynx in which radiotherapy was used as the curative treatment. A 73-year-old man presented with a sore throat that had persisted for 6 months. Examination revealed a superficial, smooth tumorous lesion at the base of his tongue with a red hue in the oropharynx. In addition, a protruding tumor was observed on the mucosal surface in the right piriform recess of the hypopharynx, and computed tomography revealed thickening of the pharyngeal wall at the right tongue base and in the right piriform recess of the hypopharynx. Because no definitive diagnosis could be reached for the lesion at the base of the tongue, the entire tongue-base tumor was resected by transoral surgery under endoscopy. Proliferation of plasma cells in the tumor was detected, and a bone marrow puncture test ruled out multiple myeloma leading to a definitive diagnosis of Stage I (cT1N0M0) squamous cell carcinoma in the right piriform recess of the hypopharynx and primary extramedullary plasmacytoma in the oropharynx. Radiotherapy was selected for curative treatment with a complete response for both cancers. No recurrences have been observed as of 12 months postoperatively.
我们报告一例罕见的下咽鳞状细胞癌与口咽髓外浆细胞瘤(EPM)同时发生的病例,该病例采用放射治疗作为根治性治疗手段。一名73岁男性因持续6个月的咽痛前来就诊。检查发现其舌根处有一浅表、光滑的肿瘤性病变,口咽处呈红色。此外,在下咽右侧梨状窝的黏膜表面观察到一个突出的肿瘤,计算机断层扫描显示下咽右侧舌根和右侧梨状窝处的咽壁增厚。由于无法对舌根处的病变做出明确诊断,遂在内镜下经口手术切除了整个舌根肿瘤。检测发现肿瘤中有浆细胞增殖,骨髓穿刺检查排除了多发性骨髓瘤,最终确诊为下咽右侧梨状窝I期(cT1N0M0)鳞状细胞癌和口咽原发性髓外浆细胞瘤。选择放射治疗作为根治性治疗,两种癌症均获得完全缓解。截至术后12个月,未观察到复发情况。