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喉梭形细胞癌:一例报告。

Spindle cell carcinoma of larynx: A case report.

作者信息

Ahmad Syed Anwar, Iqbal Asma, Bokhari Syed Faqeer Hussain, Sial Fatima

机构信息

King Edward Medical University, Mayo Hospital, Lahore, Pakistan.

King Edward Medical University, Mayo Hospital, Lahore, Pakistan.

出版信息

Int J Surg Case Rep. 2024 Sep;122:110015. doi: 10.1016/j.ijscr.2024.110015. Epub 2024 Jul 6.

Abstract

INTRODUCTION AND IMPORTANCE

Laryngeal Spindle Cell Carcinoma (SpCC), a rare subtype constituting only 0.5% of cases, poses diagnostic challenges due to its biphasic nature and histological resemblance to other neoplasms. Our study explores unique observations, including monoclonal epithelial origin and an unusually large tumor triggering respiratory distress.

CASE REPORT

In this comprehensive case report, a 62-year-old male with a history of tuberculosis and extensive smoking presented with respiratory distress and a white vocal cord mass, diagnosed as spindle cell carcinoma (SpCC). Laryngoscopic and imaging evaluations revealed an ill-defined mass originating from the right supraglottic larynx. Histopathological examination and immunohistochemistry confirmed confirming the diagnosis. The management included immediate tracheostomy, surgical resection, adjuvant radiation therapy, and chemotherapy. Regular follow-ups and a multidisciplinary approach contributed to a successful three-year outcome without recurrence.

CLINICAL DISCUSSION

Spindle Cell Carcinomas (SpCCs) of the larynx, historically termed carcinosarcoma and sarcomatoid carcinoma, are rare and predominantly affect middle-aged to elderly males. These biphasic tumors arise from both epithelial and spindle cell elements and present with symptoms like hoarseness and dysphagia. Risk factors include tobacco use, alcohol, and viral infections. Accurate diagnosis relies on histological and immunohistochemical analysis. Early detection facilitates favorable outcomes, with five-year survival rates ranging from 65 to 95%.

CONCLUSION

Spindle Cell Carcinoma (SpCC) of the larynx, originating from epithelial and spindle cell elements, requires early detection through histological and immunohistochemical analysis. Early diagnosis leads to a notably optimistic five-year survival prognosis.

摘要

引言与重要性

喉梭形细胞癌(SpCC)是一种罕见的亚型,仅占病例的0.5%,由于其双相性以及在组织学上与其他肿瘤相似,给诊断带来了挑战。我们的研究探索了独特的观察结果,包括单克隆上皮起源以及一个异常大的肿瘤引发呼吸窘迫。

病例报告

在这份全面的病例报告中,一名有肺结核病史且大量吸烟的62岁男性因呼吸窘迫和声带白色肿物就诊,被诊断为梭形细胞癌(SpCC)。喉镜和影像学评估显示一个边界不清的肿物起源于右侧声门上喉。组织病理学检查和免疫组织化学确诊了诊断。治疗包括立即气管切开、手术切除、辅助放疗和化疗。定期随访以及多学科方法促成了三年无复发的成功结果。

临床讨论

喉梭形细胞癌(SpCCs),历史上称为癌肉瘤和肉瘤样癌,较为罕见,主要影响中年至老年男性。这些双相性肿瘤起源于上皮和梭形细胞成分,表现为声音嘶哑和吞咽困难等症状。风险因素包括吸烟、饮酒和病毒感染。准确诊断依赖于组织学和免疫组织化学分析。早期发现有助于取得良好结果,五年生存率在65%至95%之间。

结论

喉梭形细胞癌(SpCC)起源于上皮和梭形细胞成分,需要通过组织学和免疫组织化学分析进行早期检测。早期诊断会带来显著乐观的五年生存预后

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe3f/11314860/3c62263f4832/gr1.jpg

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