Imperial College Healthcare NHS Trust, London, UK
Imperial College London Faculty of Medicine, London, UK.
BMJ Case Rep. 2020 Dec 13;13(12):e235768. doi: 10.1136/bcr-2020-235768.
A man in his mid 70s was referred to head and neck outpatients with bulky tissue in the left tonsillar fossa. He had previously been treated for oligometastatic renal clear cell carcinoma (diagnosed over 15 years prior to disease recurrence) by tonsillectomy and adjuvant radiotherapy (years from primary treatment), followed by trans-oral laser surgery to his oropharyngeal recurrence 3 years later. Examination under anaesthetic and biopsy confirmed further recurrence of disease in the left tonsillar fossa, with parapharyngeal extension, which has not been previously reported in the literature. After discussion in the head and neck and urology multi-disciplinary teams meeting, the patient was offered trans-oral robotic-assisted surgery (TORS) for local control and prevention of progression of a fungating oropharyngeal mass. TORS partial pharyngectomy and left buccal artery myomucosal flap reconstruction were successfully carried out, with preservation of some swallow function.
一位 70 多岁的男性因左侧扁桃体窝内大量组织而被转诊到头颈门诊。他曾因寡转移肾透明细胞癌（在疾病复发前 15 多年诊断）接受扁桃体切除术和辅助放疗（从初次治疗开始的年数），随后因口咽复发接受经口激光手术 3 年后。全身麻醉下检查和活检证实左侧扁桃体窝内疾病进一步复发，并向咽旁延伸，这在文献中尚未报道过。在头颈和泌尿科多学科团队会议讨论后，为了局部控制和防止口咽肿块的进展，为该患者提供了经口机器人辅助手术（TORS）。成功地进行了 TORS 部分咽切除术和左侧颊动脉肌黏膜瓣重建，保留了部分吞咽功能。
