Gao Y, Yang H, Chen F, Lv D, Chen Y, Chen Y Z
Department of Otorhinolaryngology,Chengdu Shangjin Nanfu Hospital, Chengdu, 611743,China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Nov;32(21):1660-1664. doi: 10.13201/j.issn.1001-1781.2018.21.013.
To discuss the clinical diagnosis, therapies and prognosis of adenoid cystic carcinoma of external auditory canal.Eleven patients with adenoid cystic carcinoma of external auditory canal, who had been admitted to West China hospital, Sichuan university from April 2009 to October 2015 were recruited and a retrospective analysis was performed.All the 11 patients were treated with surgery except one elderly with T1 stage who was only treated with radiotherapy(RT),1 of the 10 patients treated with surgery were added on radiotherapy after surgery. Following up for 12-104 months,the patient who was treated with RT alone has survived with carcinoma for 51 months by now,among the remainder stage T1 patients,one was reoperated for local recurrence 95 months after surgery, and therefore survived without recurrence.The other 2 patients all survived with free-disease;in the stage T2 patients,one was lost to follow-up after identified local recurrence with pulmonary masses 12 months after surgery, another one committed suicide because of family problems 56 months after operation,and the other one survived without recurrence for 57 months after surgery; the stage T3 patient survived without recurrence for 26 months at present;in the T4 patients, one died after gamma knife therapy for local recurrent disease with brain metastasis 22 months after surgery, another one died from pulmonary metastasis 17 months after surgery,and the other one survived without recurrence for 56 months.Adenoid cystic carcinoma of external auditory canal is a rare disease with high misdiagnosis rate and progresses slowly.Surgery is the preferred therapy.The prognosis is closely related to disease clinical stage at presentation type of pathology and surgical approaches. Adenoid cystic carcinoma of external auditory canal is characteristically susceptible to local recurrence and distant metastasis,inaddition to routine re-exam of ear,the patients should be reviewed carefully to exclude of pulmonary,brain and kidney metastasis during follow-up.
探讨外耳道腺样囊性癌的临床诊断、治疗及预后。选取2009年4月至2015年10月在四川大学华西医院收治的11例外耳道腺样囊性癌患者进行回顾性分析。11例患者中,除1例T1期老年患者仅行放疗外,其余10例均行手术治疗,其中1例行手术加术后放疗。随访12 - 104个月,单纯放疗患者至今已带癌生存51个月,其余T1期患者中,1例术后95个月因局部复发再次手术,目前无瘤生存;另2例均无瘤生存;T2期患者中,1例术后12个月发现局部复发伴肺部肿块后失访,另1例术后56个月因家庭问题自杀,1例术后57个月无瘤生存;T3期患者目前无瘤生存26个月;T4期患者中,1例术后22个月因局部复发病灶伴脑转移行伽马刀治疗后死亡,另1例术后17个月死于肺转移,1例术后56个月无瘤生存。外耳道腺样囊性癌是一种少见病,误诊率高,进展缓慢。手术是首选治疗方法。预后与疾病临床分期、病理类型及手术方式密切相关。外耳道腺样囊性癌易发生局部复发和远处转移,除常规耳部复查外,随访期间应仔细检查以排除肺、脑及肾转移。