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1
題名:METASTATIC CARDIAC TUMOR FROM PRIMARY TONGUE CANCER: A CASE REPORT     (12點)
原發性舌癌伴隨心臟轉移:病例報告及文獻探討
著者:Tzu-Hwei Wang(王慈慧) ;Wen-Shan Liu(劉文山)
出版地區:台灣
出版城市:台北市
學科:醫學綜合
關鍵字:舌癌 ; 心臟轉移 ; 心包膜填塞 ; Tongue cancer ; Cardiac metastasis ; Cardiac tamponade
刊名:Therapeutic Radiology and Oncology
頁碼:241-246
語言:英語
摘要: 中文摘要PDF ; 英文摘要PDF

目的:原發性舌癌伴隨心臟轉移的病例非常罕見,我們報告一病患以心包膜填塞為表現的病例,經開刀後證實是轉移性鱗狀上皮癌。 病例報告:一位年紀67 歲的男性患者,在2004 年3 月時被確定診斷出左側鱗狀上皮舌癌,當時癌症分期為T2N0M0 。病人在外院接受了局部舌切除後,無佐以其他輔助治療。不幸的,在2004 年10 月時,左側下頷骨淋巴節復發,病人自行轉診至本院,經檢查後確定無遠處轉移。病人在10 月時接受了同步化學治療及放射治療,從2004 年10 月至2004 年12 月,總共接受了6 次化學治療及79.8 Gy 記38 次的放射線治療。治療期間,除了有WHO Grade II 的黏膜反應外,治療堪稱平順。然而不幸的, 2005 年2 月病人有頑固性心包膜滲液產生並導致心包膜填塞。心臟超音波及胸部斷層掃瞄均發現在右心室有一腫瘤及心包膜滲液;由於持續性心臟功能惡化,為了改善心臟功能,心臟外科醫師在2 月24 日施行腫瘤摘除手術,從右心室取出一個3.3 × 2.7 × 2.0 公分大小的腫瘤。經病理確定診斷為轉移性鱗狀上皮癌。 結果:術後我們施予加強性支持療法,然而病人仍於2005 年3 月7 日因心衰竭逝世。 結論:雖然轉移性心臟腫瘤的病例極為少見,但在頭頸部腫瘤中,舌癌算是較常見的。由於腫瘤心臟轉移時並無特定表現的病徵;且轉移後,病人通常處於危急狀態,所以臨床要診斷轉移性心臟腫瘤很困難。我們必須注意的是,舌癌患者,一旦出現新的心臟疾病,心臟轉移的診斷不可被忽略。
Purpose : To report a case of cardiac metastasis from primary squamous cell carcinoma of tongue presented as malignant pericardial effusion causing cardiac tamponade. This case was proven by pathologic evidence. Case report : This 67 years old male patient was diagnosed of left tongue carcinoma with initial staging of T2N0M0 and received local excision in March 2004 in another hospital. However, left submandibular lymph node recurrence occurred in October 2004. Restaging work-up was arranged and no evidence of distant metastasis was found. Then he received salvage treatment of concurrent chemo-radiotherapy (CCRT) since October 28, 2004. For radiotherapy, the total dose to recurrent LN and primary tumor bed with whole lymphatic chain were 79.8 Gy and 62.4 Gy, respectively. The regimen of chemotherapy was taxotere (12 mg/m2) plus cisplatin (30 mg/m2) weekly for 6 cycles. The total treatment course was completed smoothly on December 24, 2004 except for WHO Grade II mucositis that developed during treatment period. Unfortunately, pericardiac effusion occurred as diagnosed by cardiac echography in February 2005. Refractory pericardiac effusion caused cardiac tamponade was still persistent despite of repeated pericardiocentesis. Chest computed tomography (CT) showed that a mass within the right ventricle and massive pericardiac effusion. Surgery was performed owing to progressive degradation of cardiac function on February 24, 2005. Result : The myocardiac tumor biopsy proved metastatic squamous cell carcinoma. Unfortunately, this patient died of heart failure even after intensive supportive treatment, 12 days after surgery. Conclusion : Although primary tongue cancer is frequent in head and neck tumor, metastatic cardiac cancer is a rare occurrence. The diagnosis of metastasis to heart is difficult because of various cardiac symptoms. Most importantly, the diagnosis of cardiac metastasis should be kept in mind if a new onset of cardiac disease occurred in cancer patient.


    

本卷期目次
Therapeutic Radiology and Oncology
鈷-60輻射污染鋼筋建物居民輻射風險因子之研究/ 蔡顯智許世明張國華陳為立
Long-Term Survival with No Evidence of Brain Metastasis in 6 Patients of Limited-Stage Small Cell Lung Cancer Receiving Prophylactic Cranial Irradiation/ Chia-Chun HuangMu-Tai LiuChu-Ping PiTung-Hao ChangWen-Shan LiuChao-Yuan Huang
動態準直儀葉片於虛擬楔形濾板之研究/ 邱仲峰黃光偉李俊信顏上惠蕭正英陳培勳蔡若婷李玉麟陳良光
強度調控式放射治療之劑量驗證/ 梁基安蕭安成蘇經雄施文彬潘佳穎
Radiotherapy in the Management of Localized Classic Kaposi's Sarcoma/ Yao-Ching WangLai-Lei TingChun-Ru ChienSung-Hsin KuoKuo-Ming HuangChao-Yuan HuangMing-Kuen LaiChia-Hsien Cheng
第一期下期與第二期上期之子宮頸癌經不同治療模式後的長期生活品質比較/ 許維中詹淑卿鍾娜娜陳宇嘉丁禮莉陳斯榮蔡崇煌王博民謝保群林高德
Treatment Results and Prognostic Factors of Esthesioneuroblastoma (ENB)/ Yu-Ming WangChong-Jong WangEng-Yen HuangHui-Chun ChenLi-Min SunFu-Min FangHsuan-Chih HsuChing-Yeh HsiungYu-Jie HuangChang-Yu Wang
Brain Stem Doses for Patients of T3/T4 Nasopharyngeal Carcinoma Treated by Bid Irradiation and Concomitant Chemotherapy/ Stella Y. C. TsaiSkye Hongiun ChengJames Jer-Min JianChao-Ming HuangK. Lawrence YenKwan-Yee ChanSzu-Yun LeuYen-Chun LinNei-Min ChuTran-Der TanCheng-Yee HsiehMei-Hua TsouChing-Yuan LinAndrew T. Huang
Metastatic Cardiac Tumor from Primary Tongue Cancer: A Case Report/ Tzu-Hwei WangWen-Shan Liu
BRAIN STEM DOSES FOR PATIENTS OF T3/T4 NASOPHARYNGEAL CARCINOMA TREATED BY BID IRRADIATION AND CONCOMITANT CHEMOTHERAPY/ Stella Y. C. TsaiSkye Hon-Giun ChengJames Jer-Min JianChao-Ming HuangK. Lawrence YenKwan-Yee ChanSzu-Yun LeuYen-Chun LinNei-Min ChuTran-Der TanCheng-Yee HsiehMei-Hua TsouChing-Yuan LinAndrew T. Huang
第一期下期與第二期上期之子宮頸癌經不同治療模式後的長期生活品質比較/ 許維中詹淑卿鍾娜娜陳宇嘉丁禮莉陳斯榮蔡崇煌王博民謝保群林高德
TREATMENT RESULTS AND PROGNOSTIC FACTORS OF ESTHESIONEUROBLASTOMA (ENB)/ Yu-Ming WangChong-Jong WangEng-Yen HuangHui-Chun ChenLi-Min SunFu-Min FangHsuan-Chih HsuChing-Yeh HsiungYu-Jie HuangChang-Yu Wang
RADIOTHERAPY IN THE MANAGEMENT OF LOCALIZED CLASSIC KAPOSI'S SARCOMA/ Yao-Ching WangLai-Lei TingChun-Ru ChienSung-Hsin KuoKuo-Ming HuangChao-Yuan HuangMing-Kuen LaiChia-Hsien Cheng
LONG-TERM SURVIVAL WITH NO EVIDENCE OF BRAIN METASTASIS IN 6 PATIENTS OF LIMITED-STAGE SMALL CELL LUNG CANCER RECEIVING PROPHYLACTIC CRANIAL IRRADIATION/ Chia-Chun HuangMu-Tai LiuChu-Ping PiTung-Hao ChangWen-Shan LiuChao-Yuan Huang
動態準直儀葉片於虛擬楔形濾板之研究/ 邱仲峰黃光偉李俊信?上惠蕭正英陳培勳蔡若婷李玉麟陳良光
強度調控式放射治療之劑量驗證/ 梁基安蕭安成蘇經雄施文彬潘佳穎
鈷-60輻射污染鋼筋建物居民輻射風險因子之研究/ 蔡顯智許世明張國華陳?立
METASTATIC CARDIAC TUMOR FROM PRIMARY TONGUE CANCER: A CASE REPORT/ Tzu-Hwei WangWen-Shan Liu
 
   
 
   

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