Hanna E
Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
Am J Otolaryngol. 1996 Sep-Oct;17(5):353-7. doi: 10.1016/s0196-0709(96)90025-3.
Squamous cell carcinoma arising in a TGDC is a rare event, and a high index of suspicion is therefore needed for reaching a correct preoperative diagnosis to plan adequate therapy. The work-up should include fine needle aspiration cytology and high-resolution CT scan. The recommended therapy is adequate wide resection with frozen section control of the surgical margins. For localized lesions within the TGDC (diagnosed as an incidental histological finding), the Sistrunk operation is adequate. If, however, the tumor invades surrounding structures, wider resections (which may include strap muscles, thyroid, larynx, or base of tongue) are recommended. Neck dissection is reserved for cases with nodal metastasis. There is no role for prophylactic neck dissections except perhaps for the paratracheal nodes. Postoperative radiation therapy is recommended for larger lesions, positive surgical margins, or extensive nodal disease. Strict follow-up is recommended for prolonged periods of time, because local recurrences are common and could occur many years after the initial treatment.
起源于鳃裂囊肿的鳞状细胞癌是一种罕见事件，因此需要高度怀疑指数才能做出正确的术前诊断以规划适当的治疗。检查应包括细针穿刺细胞学检查和高分辨率CT扫描。推荐的治疗方法是进行充分的广泛切除，并对手术切缘进行冰冻切片检查。对于鳃裂囊肿内的局限性病变（诊断为偶然的组织学发现），Sistrunk手术就足够了。然而，如果肿瘤侵犯周围结构，则建议进行更广泛的切除（可能包括带状肌、甲状腺、喉或舌根）。颈部清扫术仅适用于有淋巴结转移的病例。除了气管旁淋巴结外，不建议进行预防性颈部清扫。对于较大的病变、手术切缘阳性或广泛的淋巴结疾病，建议术后进行放射治疗。建议进行长期严格随访因为局部复发很常见，可能在初始治疗多年后发生。
