Guo Yuxin, Pang Maria Cui-Ying, Teo Constance Ee-Hoon, Chng Jack Kian
Department of Vascular Surgery, Singapore General Hospital, Singapore.
Department of Otolaryngology, Head and Neck Surgery, Singapore General Hospital, Singapore.
Ann Vasc Surg. 2019 Apr;56:355.e11-355.e15. doi: 10.1016/j.avsg.2018.09.027. Epub 2018 Nov 27.
Surgical management of advanced head and neck tumors involving the carotid artery remains controversial with compromised survival outcomes and heightened risks of morbidity and mortality.
We describe a case of a 74-year-old lady with previous T1N0M0 left tongue squamous cell carcinoma, who developed a left nodal recurrence encasing the left external carotid artery from the carotid bifurcation. She underwent an extended left radical neck dissection with carotid artery patch plasty and remains well to date, 10 months after surgery.
Head and neck tumor recurrences are not uncommon, and radical resection of advanced tumors involving the carotid artery is increasingly performed. Various carotid interventions including tumor peeling, ligation, and resection with reconstruction were reported with differences in survival outcomes, morbidity and mortality.
An aggressive surgical approach to advanced tumors involving the carotid artery may be a viable attempt for survival prolongation but requires proper case selection and has to be weighed against the risks of complications to better optimize patient outcomes.
涉及颈动脉的晚期头颈部肿瘤的手术治疗仍存在争议，生存结果受到影响，发病和死亡风险增加。
我们描述了一例74岁女性，既往有T1N0M0期左舌鳞状细胞癌，出现左颈部淋巴结复发，肿瘤包绕左颈外动脉至颈动脉分叉处。她接受了扩大的左颈根治性清扫术及颈动脉补片成形术，术后10个月至今情况良好。
头颈部肿瘤复发并不少见，涉及颈动脉的晚期肿瘤的根治性切除越来越多地被实施。据报道，各种颈动脉干预措施包括肿瘤剥离、结扎以及切除后重建，在生存结果、发病率和死亡率方面存在差异。
对于涉及颈动脉的晚期肿瘤采取积极的手术方法可能是延长生存期的一种可行尝试，但需要正确选择病例，并且必须权衡并发症风险，以更好地优化患者预后。
