11例头颈部肉瘤样癌临床分析

Sarcomatoid carcinoma of head andneck:A report of 11 cases

摘要:

目的 探讨头颈部肉瘤样癌的临床与病理学特点，以提高对肉瘤样癌的诊断、治疗及判断其预后的认识。方法 回顾性分析2005年8月~2011年4月经手术治疗的11例头颈部肉瘤样癌 患者的临床资料及诊疗过程。结果 11例患者，其中发生于喉部2例、下咽部5例、鼻窦2例、舌根部1例、颞部1例。所有患者均经相应的术式及对症支持治疗后随访7~55个月，平均随访15.5个月。其中5例存活、3例死亡、3例失访。5例存活患者中2例患者出现可疑肺、颈椎转移。结论 肉瘤样癌有其特殊的生物学行为及病理学特点，确诊依赖于免疫组化；对无远处转移的肉瘤样癌首选手术切除治疗，放疗是术后重要的辅助手段。

Abstract:

Objective To explore the biological behavior of the sarcomatoid carcinoma (SC) of head neck for improving the diagnosis, treatment and judgment of prognosis of the tumor. Methods Clinical data of the 11 cases of SC underwent operation in our department from 2005 to 2011 was analyzed retrospectively. Results Of all the patients, 10 were male and 1 was female with a male to female ratio of 10:1.The ages of the patients ranged from 33 to 71 with a median age of 51. The involved organs included larynx (2 cases), hypophargnx (5 cases) , paranasal sinuses (2 cases) , tongue base (1 case) , and temporal bone (1 case) . 8 cases were followed up and 3 were lost. The followup duration ranged from 7 to 55 months (median 15.5 months). 5 patients survived, 3 died and 3 got loss of followup. Two of the survivals have suspicious metastasis of the lung and cervical vertebra. Conclusion The final diagnosis of SC depends on the immunohistochemistry due to its specific biological behaviors and pathological characteristics. The surgical operation is the first choice for SC without metastasis. Radiotherapy is an important accessory treatment to operation，but its role in the prevention of local recurrence and metastasis still needs further investigation.