A case of treatment-related myelodysplastic syndrome in the early stage after radiotherapy in a patient with cancer of the oral floor

IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Journal of Oral and Maxillofacial Surgery Medicine and Pathology Pub Date : 2024-04-13 DOI:10.1016/j.ajoms.2024.04.004
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Abstract

Therapy-related myelodysplastic syndrome (t-MDS) is a rare but potentially fatal adverse event caused by chemotherapy or radiotherapy. We report a case of t-MDS diagnosed 8 months after radiotherapy for recurrent carcinoma of the floor of the mouth and cervical lymph node metastases after surgical treatment. A 74-year-old man visited our department with the chief complaint of pain in the lower part of the tongue. Tumor resection and right radical neck dissection (RND) were performed based on the diagnosis of carcinoma of the floor of the mouth (cT1N2bM0). A computed tomography scan at 10 months postoperatively showed metastatic lymph nodes in the left neck, right hyoid bone, right parotid subpolar, and anterior trachea. Therefore, the patient underwent left RND and excision of the right hyoid bone, subpolar right parotid and anterior tracheal metastatic lymph nodes. Postoperative radiation therapy (70 Gy) was administered to the neck bilaterally. An upper gastrointestinal examination revealed a carcinoma in situ in the lower esophagus, and endoscopic submucosal dissection of the esophagus was performed. He had pancytopenia preoperatively, which progressed postoperatively; therefore, a bone marrow examination was performed to rule out a hematological malignancy. Bone marrow smear and flow cytometric analyses indicated the development of t-MDS. He received supportive transfusion therapy but died 8 months after the diagnosis of t-MDS. During post-treatment follow-up, clinicians should be aware of t-MSD, in addition to cancer recurrence and metastasis.

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一例口腔底癌患者放疗后早期出现的与治疗相关的骨髓增生异常综合征
治疗相关骨髓增生异常综合征(t-MDS)是化疗或放疗引起的一种罕见但可能致命的不良反应。我们报告了一例因口腔底癌复发和手术治疗后颈淋巴结转移而接受放疗8个月后确诊的t-MDS病例。一名 74 岁的男性来我科就诊,主诉为舌头下部疼痛。根据口底癌(cT1N2bM0)的诊断,医生为其进行了肿瘤切除和右侧颈部根治性切除术(RND)。术后 10 个月的计算机断层扫描显示,左颈部、右舌骨、右腮腺下极和气管前部出现转移淋巴结。因此,患者接受了左侧 RND 和右舌骨、右腮腺下极和气管前转移淋巴结切除术。术后对双侧颈部进行了放疗(70 Gy)。上消化道检查发现食道下段有原位癌,于是进行了内镜下食道黏膜下剥离术。他术前有全血细胞减少,术后病情恶化,因此进行了骨髓检查以排除血液恶性肿瘤。骨髓涂片和流式细胞分析表明他患上了 t-MDS。他接受了输血支持治疗,但在确诊为 t-MDS 8 个月后死亡。在治疗后的随访中,除了癌症复发和转移外,临床医生还应注意 t-MDS。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
0.80
自引率
0.00%
发文量
129
审稿时长
83 days
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