喉疣状癌的诊断与治疗(3例报告及文献复习)

Diagnosis and management of laryngeal verrucous carcinoma(report of 3 cases and review of literature)

目的 探讨喉疣状癌的诊断与治疗。方法对 3例喉疣状癌的临床、病理、诊断、治疗及预后进行回顾性分析。结果 3例喉疣状癌患者均为男性, 年龄 51 ~59岁, 平均年龄 56岁。喉疣状癌诊断较困难, 应反复多次活检才能确诊。其中 1例先后进行两次手术、1次放疗,终因肿瘤复发、组织间变、淋巴转移、肺感染、吞咽梗阻致全身衰竭死亡。2例行喉垂直部分切除术, 随访 5 ~6年无复发。结论 喉疣状癌容易误诊, 追踪观察肿瘤生长方式、外观形态和病理学检查可确诊。喉疣状癌以手术治疗为主, 切除力求彻底, 手术方式首选喉垂直部分切除术。放射治疗不敏感。

OBJECTIVETo explore the diagnosis and treatment of laryngeal verrucous carcinoma METHODS The clinical and pathologic features of 3 cases with verrucous carcinoma were analyzed retrospectively RESULTSAll the 3 cases with verrucous carcinoma were male The age ranged from 51 to 59 years with average 56 years The diagnosis of verrucous carcinoma was so difficult that the final diagnosis needed repeated biopsy 1 case underwent operation for two times and radiotherapy for one time,which finally died of multiple organ failure caused by tumor recurrence,tissue anaplasia,lymphatic metastasis,pulmonary infection and obstruction of deglutition The other 2 cases underwent hemilaryngectomy They were followed up for 5 to 6 years and no patient was found recurrence CONCLUSION The misdiagnosis of verrucous carcinoma was prone to be made The final diagnosis relied on pathological examination as well as the observation of tumor , s growth mode and outward appearance The main treatment of verrucous carcinoma was complete excision The verticval partial laryngectomy was the optimum management for verrucous carcinoma and the tumor was insensitive to radiotherapy