Zuzana Horakova, Lukáš Velecky, Marta Pazourkova, Pavla Urbánková, Pavel Smilek
Klin Onkol. 2018 Summer;31(4):296-300. doi: 10.14735/amko2018296.
Primary branchiogenic carcinoma (BC) is an exceptional diagnostic entity. In most cases, suspicion of BC is confirmed to be a cystic lymph node metastasis of an occult primary tumor. Martin and Khafif therefore established diagnostic criteria, emphasizing above all the importance of a histologically assessed transformation of cystic lining epithelium into an invasive squamous cell carcinoma in one pathological lesion after the exclusion of a primary tumor.
We present a case report of an 80-year-old patient who presented for a follow-up for an 8-year history of a benign lateral cervical cyst, which was not surgically treated due to the patients high risk of complications from general anesthesia. In spite of the risk, the surgery was performed after a sudden clinical progression, and surprisingly, post-operative histology revealed BC. Conslusion: BC is a very rare entity, strictly defined by Martins and Khafifs criteria. Recently, BCs have been presented in the literature only as unique case reports responding as in our patient to the above mentioned criteria, with particular emphasis on the histological aspect, imaging the cystic lining epithelium transforming into an invasive squamous cell carcinoma in one pathological lesion and a long history without evidence of primary tumor. Key words: branchiogenic carcinoma - lateral branchial neck cyst - occult carcinoma - metastasis of unknown primary origin.
原发性鳃源性癌(BC)是一种罕见的诊断实体。在大多数情况下,BC的疑似病例被证实为隐匿性原发性肿瘤的囊性淋巴结转移。因此,马丁(Martin)和哈菲夫(Khafif)制定了诊断标准,首先强调在排除原发性肿瘤后,在一个病理病变中经组织学评估囊性衬里上皮转变为浸润性鳞状细胞癌的重要性。
我们报告一例80岁患者的病例,该患者因良性颈侧囊肿有8年病史前来复诊,由于患者全麻并发症风险高,此前未接受手术治疗。尽管有风险,但在临床突然进展后仍进行了手术,令人惊讶的是,术后组织学检查显示为BC。结论:BC是一种非常罕见的实体,严格按照马丁和哈菲夫的标准定义。最近,文献中报道的BC仅为符合上述标准的独特病例报告,尤其强调组织学方面,即影像学显示在一个病理病变中囊性衬里上皮转变为浸润性鳞状细胞癌且长期无原发性肿瘤证据。关键词:鳃源性癌 - 颈侧鳃裂囊肿 - 隐匿性癌 - 原发灶不明的转移瘤