А. Zaytsev, А. P. Polyakov, М. V. Ratushny, Т. М. Kobyletskaya, S. Kisariev, А. L. Sugaipov, О. N. Kirsanova
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引用次数: 0
摘要
本科学报告的目的是描述一个罕见的临床病例,弗赖斯节病(弥漫性特发性骨骼肥厚症)和喉癌合并有共同的症状。病例报告。男性,68岁,声嘶力竭一年。间接喉镜检查发现声带肿瘤。组织学检查证实为喉部高分化角化鳞状细胞癌。一个6厘米的肿瘤位于右侧声带的突出处,没有侵犯声门上、声门下和前联合的迹象。未发现其他局灶性疾病。患者接受了喉内激光切除和气管切开术。取出探头后,患者出现吞咽困难,食管内容物进入气管,主要是由于С З -С 4段颈椎器质性改变,前纵韧带局部大量钙化。我们还注意到颈椎严重的活动受限:活动幅度不超过10°。通过腹外侧入路切除c3 - c4节段。结论。吞咽困难、发音困难和呼吸困难可能提示恶性肿瘤和造成气管和食道压迫的大骨赘。在这个病例中,肿瘤切除后症状没有缓解,导致怀疑第二种疾病,即弗赖斯节病。
Combination of Forestier’s disease and laryngeal cancer: a rare clinical case
The objective of the scientific report is to describe a rare clinical case of a combination of Forestier’s disease (diffuse idiopathic skeletal hyperostosis) and laryngeal cancer that have common symptoms. Case report. A 68-year-old male patient presented with hoarseness lasting for a year. Indirect laryngoscopy revealed a vocal fold tumor. Histological examination confirmed well-differentiated keratinizing squamous cell carcinoma of the larynx. A 6-cm tumor was located in the projection of the right vocal fold and had no signs of invasion into the supraglottis, subglottis, and anterior commissure. No other focal disorders were detected. The patient has undergone endolaryngeal laser resection of the larynx and tracheostomy. After probe removal, the patient had swallowing difficulties with esophageal content passing to the trachea mainly due to organic changes in the cervical spine at the С З –С 4 level, where there was a massive local calcification of the anterior longitudinal ligament. We also noticed severe movement restriction in the cervical spine: the amplitude of movements did not exceed 10°. The formation of the C 3 –C 4 segment was removed via ventrolateral approach. Conclusion. Dysphagia, dysphonia, and dyspnea may indicate both malignant tumor and large osteophyte causing compression of the trachea and esophagus. In this case, no symptom resolution after tumor removal led to the suspicion of a second disease, namely Forestier’s disease.