枝源性癌鉴别诊断的临床争议。

IF 0.4 Q4 OTORHINOLARYNGOLOGY Case Reports in Otolaryngology Pub Date : 2022-09-16 eCollection Date: 2022-01-01 DOI:10.1155/2022/4582262
Alexander Karatzanis, Kleanthi Mylopotamitaki, Eleni Lagoudaki, Emmanuel Prokopakis, Sofia Agelaki
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引用次数: 1

摘要

临床评估、鉴别诊断和颈部肿块的处理是头颈部外科医生经常遇到的问题。成人无症状颈部肿块可能是头颈癌的唯一临床征象。一个50岁的女性病人表现为无痛,缓慢扩大,左侧颈部肿块。超声检查显示可能有淋巴结伴囊性变性,细针穿刺活检仅检出鳞状上皮的非典型细胞。全麻下行开放性活检。组织病理学结果提示原发部位未知的鳞状细胞癌淋巴结浸润,但鉴别诊断也包括鳃裂囊肿引起的鳃裂癌。一个诊断算法转移鳞状细胞癌的未知原发部位遵循,包括正电子发射断层扫描与计算机断层扫描。患者接受了全内窥镜检查和双侧扁桃体切除术,发现同侧p16阳性扁桃体鳞状细胞癌。随后进行了进一步的适当管理。真正的枝源性癌的存在是有争议的。当考虑这样的诊断时,应尽一切努力发现可能的原发部位。如果存在支原性癌,仍然是一种排除性诊断。
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Clinical Controversy Surrounding the Differential Diagnosis of Branchiogenic Carcinoma.

Clinical evaluation, differential diagnosis, and management of a neck mass constitute commonly encountered problems for the head and neck surgeon. An asymptomatic neck mass in adults may be the only clinical sign of head and neck cancer. A 50-year-old female patient presented with a painless, slowly enlarging, left lateral neck lump. Ultrasonography described a possible lymph node with cystic degeneration, and fine needle aspiration biopsy only detected atypical cells of squamous epithelium. An open biopsy under general anesthesia was performed. Histopathological findings suggested the diagnosis of lymph node infiltration by squamous cell carcinoma of an unknown primary site, but differential diagnosis also included branchiogenic carcinoma arising in a branchial cleft cyst. A diagnostic algorithm for metastatic squamous cell carcinoma of an unknown primary site was followed, including positron emission tomography with computed tomography. The patient underwent panendoscopy and bilateral tonsillectomy, and an ipsilateral p16 positive tonsillar squamous cell carcinoma was detected. Further appropriate management followed. The existence of true branchiogenic carcinoma is controversial. When such a diagnosis is contemplated, every effort should be made to detect a possible primary site. Branchiogenic carcinoma, if exists at all, remains a diagnosis of exclusion.

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来源期刊
Case Reports in Otolaryngology
Case Reports in Otolaryngology OTORHINOLARYNGOLOGY-
自引率
0.00%
发文量
20
审稿时长
13 weeks
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