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題名 | 喉部非典型類癌合併肝臟轉移--病例報告=Atypical Carcinoid Tumor of the Larynx with Liver Metastasis--A Case Report |
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作者 | 李忠俊; 吳孝平; 李奕輝; 吳傳頌; 詹光漢; 洪元宗; | 書刊名 | 慈濟醫學 |
卷期 | 16:1 2004.02[民93.02] |
頁次 | 頁63-67 |
分類號 | 416.894 |
關鍵詞 | 喉部非典型類癌; 喉部神經內分泌腫瘤; 免疫組織化學染色法; Atypical carcinoid; Neuroendocrine tumor; Immunohistochemical stain; |
語文 | 中文(Chinese) |
中文摘要 | 喉部非典性類癌屬於喉部神經內分泌腫瘤的分類之一。這種腫瘤在診斷上有時往往會造成誤診,主要是因為在組織病理下,有時不易與其他分類的腫瘤區分。因此除了病患的病史以及理學檢查外,免疫組織化學染色法在診斷上扮演著重要的角色。本病例為一71歲女性,主述聲音沙啞與吞嚥困難持續約兩個月,經由喉鏡檢查發現右側聲門上部有一直徑約三公分,橢圓形向外生長的腫瘤,於是建議病患接受喉部顯微切片手術,組織病理檢查初部懷疑為喉部神經內分泌瘤,再經由免疫組織化學染色法,發現腫瘤特殊標記chromogranin與neuron-specific enolase皆呈現陽性反應,於是確定診斷為喉部非典性類癌。由於病患拒絕接受進一步手術治療,於自動出院後一個月,病患重新回到門診時,除了已經出現呼吸困難的症狀外,也診斷出有肝臟轉移的情形,由於病情極度不穩定,先給予支持性療法來維持呼吸道及生命跡象,而病患的病情逐漸惡化,於住院後一星期死亡。因此不同分類的喉部神經內分泌腫瘤 有著不同的臨床表現及截然不同的預後,因此希望藉由正確的組織病理報告以及配合免疫組織化學染色法,能夠達到早期診斷的目的,同時選擇最適當的治療模式,來提高疾病的存活率。 |
英文摘要 | An atypical carcinoid tumor is one of the subtypes of neuroendocrine tumors of the larynx. Since neuroendocrine tumors of the larynx have heterogeneous characteristics, they are often misdiagnosed as other tumor types. Therefore, in addition to the histopathological findings, immunohistochemical staining can also play an important diagnostic role. We present the case of a 71-year-old female whose chief complaint was of hoarseness and dysphagia that persisted for about 2 months. A laryngoscopic examination revealed an outgrowing oval-shaped supraglottic mass on the right side of her arytenoepiglottic fold that was about 3 cm in diameter. We arranged laryngomicrosurgery for an excisional biopsy. Initial histopathological findings led us to suspecl that the case should be diagnosed a neuroendocrine tumor of the larynx. Immunohistochemical staining showed a positive reaction on 2 important tumor-specific markers, chromogranin and neuron-specific enolase. We confirmed the diagnosis as atypical carcinoid tumor of the larynx. Although the patient refused to accept further surgical treatment, she came back to the department a month later due to dyspnea. Apart from having this symptom, the patient was also diagnosed with liver metastasis. Since the patient's condition was extremely unstable, she was given supportive care to maintain her airway and vital signs. Nevertheless, her condition deteriorated, and she expired a week later. Different subtypes of neuroendocrine tumors of the larynx have different clinical presentations and prognose. We therefore anticipate utilizing a histopathological diagnosis to further confirm the immunohistochemical staining. This will help us achieve an earlier diagnosis and at the same time choose the best therapeutic method to improve the survival rate of patients with this condition in the future. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。