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喉癌手术切除并术后即刻放疗后发生的喉部肉芽肿:一例报告。

Laryngeal granuloma occurring after surgery for laryngeal cancer treated by surgical removal and immediate post-operative radiotherapy: A case report.

作者信息

Wu Jingyi, Jiang Tongchao, Wu Yu, Ding Lijuan, Dong Lihua

机构信息

Department of Radiotherapy.

Department of Thoracic Oncology, Hubei Cancer Hospital, Wuhan, China.

出版信息

Medicine (Baltimore). 2019 Sep;98(39):e17345. doi: 10.1097/MD.0000000000017345.

Abstract

RATIONAL

Laryngeal granulomas are benign lesion that rarely occurs after surgery of laryngeal cancer. Until now there has not been standard treatment for it.

PATIENT CONCERN

The patient was diagnosed with laryngeal neoplasm one and half a month ago. Endoscopic low-temperature plasma knife in the radical excision of left vocal cord was performed under the general anesthesia. Postoperative histopathological examination confirmed left vocal cord tumor was highly differentiated invasive squamous cell carcinoma (SCC). Then the patient suffered unexplained intermittent dyspnea which persisted nearly 1 month after the surgery. Laryngoscope examination showed granulation formation on the glottis.

DIAGNOSES

The patient was diagnosed with laryngeal granuloma 1 month after the surgery of laryngeal cancer.

INTERVENTIONS

The patient received resection of the laryngeal mass, and pathological examination confirmed the granuloma. Postoperative radiotherapy (RT) was performed within 24 hours after surgery.

OUTCOMES

The patient was followed up for 3 years after surgery and the laryngeal granuloma and laryngeal cancer did not recur during follow-up. The symptoms of intermittent dyspnea disappeared and a satisfactory outcome was achieved.

LESSONS

Usually for primary laryngeal granulomas, surgical treatment alone is not enough, because it is easy to relapse. RT within 24 hours after operation can significantly reduce the recurrence of laryngeal granuloma.

摘要

理由

喉肉芽肿是一种良性病变,在喉癌手术后很少发生。到目前为止,尚无针对它的标准治疗方法。

患者情况

患者于一个半月前被诊断为喉部肿瘤。在全身麻醉下,使用内镜低温等离子刀对左侧声带进行根治性切除。术后组织病理学检查证实左侧声带肿瘤为高分化浸润性鳞状细胞癌(SCC)。然后患者出现不明原因的间歇性呼吸困难,术后持续了近1个月。喉镜检查显示声门上有肉芽形成。

诊断

患者在喉癌手术后1个月被诊断为喉肉芽肿。

干预措施

患者接受了喉部肿物切除术,病理检查证实为肉芽肿。术后在24小时内进行了放射治疗(RT)。

结果

患者术后随访3年,随访期间喉肉芽肿和喉癌均未复发。间歇性呼吸困难症状消失,取得了满意的结果。

经验教训

通常对于原发性喉肉芽肿,仅手术治疗是不够的,因为它很容易复发。术后24小时内进行放射治疗可显著降低喉肉芽肿的复发率。

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