Division of Pulmonary Medicine, Allergy, and Rheumatology, Department of Internal Medicine, Iwate Medical University, Iwate, Japan.
Department of Molecular Diagnostic Pathology, Iwate Medical University, Iwate, Japan.
BMJ Case Rep. 2020 Oct 30;13(10):e236819. doi: 10.1136/bcr-2020-236819.
A 66-year-old male patient who had received chemoradiotherapy (CRT) for laryngeal cancer 2 years ago visited a local doctor complaining of dyspnoea and wheezing. CT scan showed narrowing of the trachea caused by a tumour. We intubated the trachea over the tumour using a bronchoscope. A week later, the truncated tracheal tumour obstructed the tracheal tube, compromising the patient's breathing. We removed the obstructed tube and inserted a new one. We submitted the tissue from the tube to a pathologist. Histopathological diagnosis was pleomorphic carcinoma, a subtype of sarcomatoid carcinoma. The mechanism of epithelial-mesenchymal transition (EMT) occurring after CRT was detected in the tumour. Because he had undergone CRT for laryngeal cancer, surgery was not indicated, and we started radiation therapy. Sarcomatoid carcinomas including pleomorphic carcinoma of the trachea are extremely rare, with few reported cases, and EMT is associated with this histological type and CRT.
一位 66 岁的男性患者，2 年前因喉癌接受了放化疗（CRT），因呼吸困难和喘息就诊于当地医生。CT 扫描显示肿瘤导致气管狭窄。我们使用支气管镜在肿瘤上方对气管进行插管。一周后，截断的气管肿瘤阻塞了气管管，使患者呼吸困难。我们取出堵塞的管子并插入新的管子。我们将管子上的组织提交给病理学家。组织学诊断为多形性癌，这是肉瘤样癌的一种亚型。在肿瘤中检测到 CRT 后发生的上皮-间充质转化（EMT）的机制。由于他曾因喉癌接受 CRT，因此不适合手术，我们开始进行放射治疗。包括气管多形性癌在内的肉瘤样癌非常罕见，报道的病例很少，并且 EMT 与这种组织学类型和 CRT 有关。
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