下咽頭混合型小細胞癌と考えられた1例

概要

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Combined small cell carcinoma (CSCC) involves small cell carcinomas and nonsmall cell carcinomas including squamous cell carcinoma (SCC). CSCC of the hypopharynx is extremely rare, with just 5 cases described to date in English literature. A 75-year-old man with CSCC of the hypopharynx seen for abnormal upper gastrointestinal endoscopic findings was found in video hypopharyngoscopy to have a right pyriform sinus tumor. Pathological biopsy findings showed SCC in situ (cTisN0M0). Radiotherapy with 70 Gy brought complete remission. A relapse three months later thought to be recurrent SCC (rT2N2cM0) at the tumor site necessitated total laryngopharyngectomy and bilateral neck dissection and free rectus abdominis flap reconstruction. Pathological findings showed small cell carcinoma. Most radiation-induced cancer arises 10 years later. We think the primary tumor was likely CSCC with SCC. After undergoing two chemotherapy courses (CBDCA+VP-16) for small cell carcinoma, the man died 4 months after surgery. We review the literature and discuss clinical features and management of this rare tumor.
2011-03-01