鳃裂癌的诊断和治疗

BRANCHIAL CLEFT CARCINOMA

目的为探讨鳃裂癌的诊断和治疗。方法分析了本院１９９２～１９９７年所收治的４例鳃裂癌临床资料。结果发病年龄为中老年人；好发部位在第二鳃弓，第一鳃弓也可发病；临床表现和颈淋巴转移癌极相似。均行手术治疗。结论认为鳃裂癌极少见，临床对怀疑为鳃裂癌的肿块，必须在排除其他部位的颈淋巴转移癌，并经病理学检查证实后方可确诊。治疗以肿块切除加同侧根治性颈淋巴清扫术为佳。

OBJECTIVE: To report 4 cases of branchial cleft carcinoma(BCC), and discusses its clinical manifestations, diagnosis and management. METHOD: 4 patients with branchial cleft carcinoma were treated in the OMS Dept. of shanghai No.9 hospital from 1992 to 1997. The clinical data of the 4 patients was retrospectively analysed, with emphasis on clinical manifestation, diagnosis and treatment. All the diagnosis was confirmed pathologically. RESULTS: Of the 4 patients with BCC, 3 were male and 1 was female. The patients' age ranged from 47 to 70 years. 3 masses were in the anterior margin of the upper 1/3 of the sternocleidomastoid muscle, 1 was in the superior posteriorto the mandibular angle. All 4 patients underwent surgical resection, 3 recieved RND simultaneously. No recurrence occured in 4 patients, thr follow up period was 1 to 5 years. CONCLUSIONS: Primary BCC was rare in clinic, it derives from residual branchial epithelium or branchial cyst. It should be differentiated from metastatic carcinoma of the cervical lymph nodes. Diagnosis is relied on pathological examination and intraoperative frozen section is necessary in treating the patients. Extended radical resection with RND is the preferred method for BCC patients and the prognosis is relatively better.