头颈部癌肉瘤3例

Three cases of head and neck carcinosarcoma

1病例报告例1,男,71岁,因憋气3h于2018年3月12日入院。患者入院前3h出现憋气,呈吸气性呼吸困难,急诊气管切开缓解憋气症状。纤维喉镜示声门区尚光滑新生物,左侧披裂固定(图1a);颈部增强MR见肿物强化不均匀(图1b),结合PET-CT考虑恶性肿瘤;病理活检示喉鳞状细胞癌。结合术中病理给予扩大喉全切+双侧Ⅱ~Ⅴ区颈部淋巴结清扫+术后放疗(30次,60Gy/次)。术后病理符合癌肉瘤,呈中分化鳞状细胞癌。免疫组织化学:CK(部分+),Vim(部分+)。随访9个月无复发,现持续随访中。

Head and neck carcinosarcoma leads to kinds of manifestations because of different original tumor sites,such as hoarseness and dyspnea in larynx,pharyngalgia and dysphagia in pharynx and compression in neck.Imaging examinations show specific occupying tumor sites and sometimes discover peripheral invasion.Pathological examination reveals both malignant squamous epithelium and interstitial tissue in these tumors,and therefore we diagnose these tumors as carcinosarcoma.