Soriano Patricia Ann U, Cabungcal Arsenio Claro A, Villafuerte Cesar Vincent L, Lahoz Anna Claudine F
Department of Otorhinolaryngology - Head and Neck Surgery, Philippine General Hospital, University of the Philippines Manila.
Acta Med Philipp. 2023 Nov 24;57(11):97-101. doi: 10.47895/amp.vi0.4915. eCollection 2023.
A 61-year-old male diagnosed with laryngeal squamous cell carcinoma presented with hoarseness, progressive dysphagia leading to aspiration, and dyspnea one month after definitive radiation therapy. Examination revealed a diffusely swollen glottis, paralyzed vocal cords, and post-radiation fibrosis. Several glottic biopsies yielded results negative for malignancy and favored radiation-induced changes. When presented with the option of further diagnostic testing with a positron emission tomography (PET) scan or an outright laryngectomy, the patient decided on the latter. Final histopathologic diagnosis was negative for recurrence of malignancy. This case demonstrates treatment dilemmas for patients with laryngeal carcinoma with uncertain recurrence wherein radical surgical management may prove to be a viable option to achieve both diagnostic certainty and ultimate relief of symptoms.
一名61岁男性被诊断为喉鳞状细胞癌，在确定性放射治疗一个月后出现声音嘶哑、进行性吞咽困难并导致误吸，以及呼吸困难。检查发现声门弥漫性肿胀、声带麻痹和放疗后纤维化。多次声门活检结果显示恶性肿瘤为阴性，支持放疗引起的改变。在面临选择进行正电子发射断层扫描（PET）进一步诊断测试或直接进行喉切除术时，患者选择了后者。最终组织病理学诊断显示恶性肿瘤无复发。该病例展示了喉癌患者复发情况不确定时的治疗困境，其中根治性手术治疗可能被证明是实现诊断确定性和最终症状缓解的可行选择。
