舌腺样囊性癌与肺腺癌双原发恶性肿瘤病例报告及文献复习

doi:10.12016/j.issn.2096-1456.2020.09.007

口腔疾病防治 ›› 2020, Vol. 28 ›› Issue (9): 586-589.DOI: 10.12016/j.issn.2096-1456.2020.09.007

舌腺样囊性癌与肺腺癌双原发恶性肿瘤病例报告及文献复习

张骞予¹(),杨培新²(),陈柏深³,王林⁴,黄志权¹()

1.中山大学孙逸仙纪念医院口腔颌面外科,广东广州（510120）
2.台山市人民医院耳鼻喉科,广东台山（529200）
3.中山大学孙逸仙纪念医院胸外科,广东广州（510120）
4.中山大学孙逸仙纪念医院病理科,广东广州（510120）

收稿日期:2020-01-14 修回日期:2020-04-27 出版日期:2020-09-20 发布日期:2020-08-24
通讯作者: 黄志权
作者简介:张骞予,医师,硕士研究生在读,Email: 623277384@qq.com|杨培新,主任医师,硕士,yangpeixinzhu@126.com
张骞予和杨培新为共同第一作者
基金资助:
广东省自然科学基金(2016A030313348);广东省自然科学基金(2019A1515011932);中央大学基础研究基金(16ykjc17);广东省科技计划协同创新与平台环境建设(2019A141405062)

Synchronous double primary malignant tumours of the tongue and lung: a case report and literature review

ZHANG Qianyu¹(),YANG Peixin²(),CHEN Boshen³,WANG lin⁴,HUANG Zhiquan¹()

1. Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
2. Department of Otolaryngology, Taishan People′s Hospital, Taishan 529200, China
3. Department of Thoracic surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
4. Department of Pathology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China

Received:2020-01-14 Revised:2020-04-27 Online:2020-09-20 Published:2020-08-24
Contact: Zhiquan HUANG

摘要/Abstract

摘要：

目的探讨舌腺样囊性癌与肺腺癌双原发恶性肿瘤病例的诊断及治疗。方法对1例舌腺样囊性癌与肺腺癌双原发恶性肿瘤的病例资料及文献进行回顾性分析。结果该患者舌根肿物有逐渐增大史,核磁共振显示双侧颈部多发肿大的淋巴结,胸部CT示右肺下叶前基底节段可见明显病变,舌肿物病理活检报告为腺样囊性癌,肺肿物病理活检报告为肺腺癌。对舌和肺部肿瘤同期行手术切除并修复舌缺损,术后未发现残留,随访期无复发,且舌部术区美学和功能的修复效果良好。文献研究支持同期手术,但需要严格掌握适应证：头颈部原发灶尚可控制,肺部病灶经影像学检查确定可以切除。结论舌腺样囊性癌和肺腺癌双原发恶性肿瘤的病例罕有报道,其相关诊断和治疗也十分困难。同期切除双原发恶性肿瘤可能获得良好的预后效果。

关键词: 舌, 肿瘤, 腺样囊性癌, 肺腺癌, 双原发性恶性肿瘤, 同期手术切除, 预后

Abstract:

Objective To investigate the diagnosis and treatment of synchronous double primary malignant tumours of the tongue and lung.Methods A case of adenoid cystic carcinoma（ACC） and lung adenocarcinoma with double primary malignancy was retrospectively analyzed.Results The tumor of patient′s tongue base gradually grew. MRI showed multiple enlarged lymph nodes on both sides of neck. CT of the chest showed obvious lesions in the anterior basal segment of the right lower lobe. The pathological biopsy of the tongue mass identified ACC, and pathological biopsy of the lung mass identified lung adenocarcinoma. The tongue and lung tumors were both surgically resected, and the tongue defect was repaired at the same time. No residue was found after surgery, and no recurrence was found during the follow-up period. The aesthetic and functional restoration of the lingual region was good.Conclusion There are few cases of adenoid cystic carcinoma and lung adenocarcinoma with double primary malignancies, and the related diagnosis and treatment are very difficult; the simultaneous removal of double primary malignant tumors may achieve good prognosis.

Key words: tongue, tumor, adenoid cystic carcinoma, lung adenocarcinoma, double primary malignant tumor, simultaneous surgical resection, prognosis

中图分类号:

R782

张骞予,杨培新,陈柏深,王林,黄志权. 舌腺样囊性癌与肺腺癌双原发恶性肿瘤病例报告及文献复习[J]. 口腔疾病防治, 2020, 28(9): 586-589.

ZHANG Qianyu,YANG Peixin,CHEN Boshen,WANG lin,HUANG Zhiquan. Synchronous double primary malignant tumours of the tongue and lung: a case report and literature review[J]. Journal of Prevention and Treatment for Stomatological Diseases, 2020, 28(9): 586-589.

图/表 2

图1 患者病灶图片及影像学检查图片

Figure 1 Images of the patient′s lesion and imaging examination a： there is a neoplasm at the base of the tongue,the white arrow indicates the lesion; b： MRI of the tongue （coronal plane）; the yellow arrow indicates the lesion;c： MRI of the tongue （transverse plane）, the yellow arrow indicates the lesion; d： CT of the lung, the yellow arrow indicates the lesion

表1 免疫组化结果

Figure 1 Results of immunohistochemistry

Lesion	Antigen	Result	Lesion	Antigen	Result
Lung	CK7	+	Tongue	CK7	+
	TTF-1	+		CK	+
	NapsinA	+		CK5/6	+
	Ki67	3%+		CK8/18	（A part）+
	P53	80%+		P63	+
	CD34	-		S100	+
	ERG	-		Actin	（weak）+
				CD117	（A part）+
				Ki67	10%+

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舌腺样囊性癌与肺腺癌双原发恶性肿瘤病例报告及文献复习

Synchronous double primary malignant tumours of the tongue and lung: a case report and literature review

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