一个功能障碍的喉困境:癌症复发还是辐射引起的损伤?
Patricia Ann U Soriano1, Arsenio Claro A Cabungcal1, Cesar Vincent L Villafuerte1
1Department of Otorhinolaryngology - Head and Neck Surgery, Philippine General Hospital, University of the Philippines Manila.
Acta medica Philippina
|November 1, 2024
概括
这一案例凸显了在放射治疗后诊断喉癌复发的挑战. 喉腔切除术提供了诊断确定性和症状缓解,当其他测试是不确定的.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 在瘤学瘤学.
- 辐射瘤学 辐射瘤学
背景情况:
- 喉状细胞癌需要确切的治疗,通常涉及放射治疗.
- 辐射后的变化可以模仿或掩盖瘤复发,使诊断复杂化.
- 不确定复发的症状患者面临困难的治疗决策.
研究的目的:
- 呈现一个喉状细胞癌的病例,辐射后的复发不确定.
- 讨论在这种情况下的诊断和治疗困境.
- 评估喉切除术在实现诊断确定性和缓解症状方面的作用.
主要方法:
- 一名61岁的喉癌患者接受了放射治疗.
- 在治疗后,患者出现了声,食障碍和呼吸障碍.
- 喉活检为恶性瘤呈阴性;考虑了PET扫描,但选择了喉切除术.
主要成果:
- 喉腔切除术后的组织病理学证实没有恶性瘤复发.
- 患者经历了手术干预后的症状缓解.
- 辐射诱导的变化是手术后的主要发现.
结论:
- 喉切除术可以成为诊断和管理喉癌复发的可行选择,当临床怀疑尽管有负面活检仍然存在时.
- 彻底的手术可以在复杂的辐射后病例中提供最终的诊断和症状解决.
- 仔细考虑诊断不确定性和患者偏好在喉癌的治疗计划中至关重要.
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