Williamson Andrew John, Haywood Matthew, Awad Zaid
Otolaryngology, Charing Cross Hospital, London, UK
Otolaryngology, Charing Cross Hospital, London, UK.
BMJ Case Rep. 2020 Feb 25;13(2):e232096. doi: 10.1136/bcr-2019-232096.
Metastatic disease to the parotid lymph nodes typically occurs secondary to head and neck and cutaneous squamous cell carcinomas (SCC). Nasal septal SCC is an exceedingly rare primary cancer that rarely spreads to regional lymph nodes. A 39-year-old man presented with left-sided cervical lymphadenopathy and nasal polyposis. Initial assessment suggested that he may have a head and neck SCC of unknown origin with nodal deposits in close proximity to the parotid gland. Cross-sectional imaging did not reveal the primary source. After further review of imaging and examination under anaesthetic, the primary SCC was found on the left nasal septum. The patient ultimately required a type 1 craniofacial resection and adjuvant chemoradiotherapy to treat the disease. Thorough investigation of the 'unknown primary' SCC including cross-sectional imaging and endoscopic examination is essential for the diagnosis of rare and unusual primary SCCs. Nasal septal SCC can be successfully managed with combined modality treatment in the form of surgical resection and chemoradiotherapy.
腮腺淋巴结转移性疾病通常继发于头颈部和皮肤鳞状细胞癌（SCC）。鼻中隔鳞状细胞癌是一种极其罕见的原发性癌症，很少扩散至区域淋巴结。一名39岁男性患者出现左侧颈部淋巴结肿大和鼻息肉。初步评估提示，他可能患有来源不明的头颈部鳞状细胞癌，且在腮腺附近有淋巴结转移。横断面成像未发现原发灶。在进一步复查影像学检查并进行麻醉下检查后，发现原发性鳞状细胞癌位于左侧鼻中隔。患者最终需要进行1型颅面切除术及辅助放化疗来治疗该疾病。对“不明原发灶”的鳞状细胞癌进行全面检查，包括横断面成像和内镜检查，对于诊断罕见和不寻常的原发性鳞状细胞癌至关重要。鼻中隔鳞状细胞癌可以通过手术切除和放化疗相结合 的综合治疗方式成功治疗。
