非小细胞肺癌双侧扁桃体转移1例并文献复习

Bilateral tonsil metastasis of non-small cell lung cancer: a case report and literature review

摘要:

目的 探讨非小细胞肺癌（NSCLC）扁桃体转移的临床诊治经验。方法 回顾性分析1例扁桃体转移性NSCLC患者的病例资料，并结合文献进行复习，进而对该疾病的临床特点、诊断与治疗进行讨论。结果 本例患者纤维支气管镜活检病理报告为NSCLC，因咽部巨大肿物妨碍呼吸、吞咽，行右扁桃体及肿瘤切除术，术后病理证实为转移性NSCLC。术后予放射、化学治疗，但很快出现左侧扁桃体及颅脑等多处转移，5个月后死亡。结论 扁桃体转移性肺癌临床少见，进展快，预后差，手术治疗能解除呼吸道梗阻。临床医生对于扁桃体异常增大时，除考虑原发性肿瘤外，还须警惕转移癌的可能；而对于肺癌患者，也须将口咽部检查纳入常规，避免漏诊。

Abstract:

Objective To explore the clinical diagnosis and treatment of non-small cell lung cancer with tonsil metastasis. Methods The data of non-small cell lung cancer with tonsil metastasis was analyzed retrospectively. The clinical features, diagnosis and treatment of the disease were discussed by reviewing the relevant literatures. Results The patient was diagnosed with non-small cell lung cancer by fiberoptic bronchoscopy. The right tonsil and tumor resection were performed due to a huge pharyngeal mass that interfered with breathing and swallowing. The patient underwent right tonsillectomy and tumor resection due to the obstruction of breathing and swallowing because of huge pharyngeal tumor. The sample of the patient by postoperative pathology was confirmed for metastatic non-small cell lung cancer. After the operation, the patient was treated with radiotherapy and chemotherapy, but the left tonsil and brain metastases occurred quickly, who died 5 months later. Conclusions It is rare for bilateral tonsil metastasis of non-small cell lung cancer with rapid progress and poor prognosis. Surgical treatment can relieve respiratory obstruction. Clinicians should not only consider the primary tumor, but also be alert to the possibility of metastatic cancer when the tonsils of the patients are abnormally enlarged. For patients with lung cancer, oropharyngeal examination should also be routine to avoid missed diagnosis.