鼻腔及咽部转移性肿瘤11例临床病理分析

摘要

目的 探讨鼻腔及咽部转移性肿瘤的临床病理特点、诊断及鉴别诊断依据.方法 对11例鼻腔及咽部转移性肿瘤患者的临床病理资料进行回顾性分析.11例患者中男7例,女4例；发病年龄46～78岁.鼻腔5例(原发肾3例、肺1例、肝1例)、鼻咽部3例(原发直肠1例、肺1例、眼睑1例)、腭扁桃体2例(原发肺1例、肝1例)及喉咽部1例(原发肝1例).11例患者在临床上无特异性的症状和体征.治疗方法为转移灶的根治性手术配合全身系统治疗.结果 组织学类型以透明细胞癌最为多见(4/11),其他依次为腺癌(2/11),肝细胞肝癌(2/11),管状腺癌(1/11),肝内胆管癌(1/11),睑板腺癌(1/11).结论 鼻腔及咽部转移性肿瘤少见,既往病史、转移灶的形态学特征及原发性肿瘤的病理学诊断是鼻腔及咽部转移性肿瘤的主要诊断依据.治疗方法为转移灶的根治性手术配合全身系统治疗.%Objective To investigate the clinicopathological characteristics,diagnosis and differential diagnosis of metastatic tumors in nasal cavity and pharynx.Methods The clinicopathological data of 11 patients was studied retrospectively with a literature review.Among 11 cases,7 patients were males and 4 females.Ages ranged from 46 to 78 years old.The sites of the metastatic tumor involvement included 5 cases of nasal cavity(3 cases derived from kidney,1 case from lung,1 case from liver),3 cases of nasopharynx(1 case derived from rectum,1 case from lung,1 case from eyelid),2 cases of palatine tonsil (1 case derived from lung,1 case from liver)and 1 case of laryngopharynx(1 case derived from liver).All cases were lack of specific clinical symptoms related to metastatic sites.The treatment was primarily based on radical metastasectomy and systemic therapy.Results Histopathologically,clear cell carcinoma was the most common(4/11),followed by adenocarcinoma(2/11),hepatocellular carcinoma(2/11),tubular adenocarcinoma(1/11),intrahepatic bile duct carcinoma(1/11)and eyelid board carcinoma(1/11).Conclusions The incidence of metastatic tumors in nasal cavity and pharynx is extremely low.The definite diagnosis mainly relies on the history of primary cancer and the morphological characteristics of matastatic tumor.The treatment is primarily based on radical metastasectomy and systemic therapy.