口腔颌面-头颈部癌肉瘤10例临床分析

doi:10.19439/j.sjos.2017.05.022

上海口腔医学 ›› 2017, Vol. 26 ›› Issue (5): 569-572.doi: 10.19439/j.sjos.2017.05.022

• 论著 • 上一篇

口腔颌面-头颈部癌肉瘤10例临床分析

何海蕾¹, 刘忠龙², 马春跃², 李晓光², 何悦²

1.南昌大学附属赣州医院暨赣州市人民医院口腔颌面外科,江西赣州 341000；
2.上海交通大学医学院附属第九人民医院·口腔医学院口腔颌面-头颈肿瘤科,上海 200011;

收稿日期:2017-01-12 修回日期:2017-05-16 出版日期:2017-10-25 发布日期:2017-11-23
通讯作者: 何悦,E-mail:yuehe@sjtu.edu.cn
作者简介:何海蕾（1980-）,男,硕士,主治医师,E-mail:hehailei006@163.com

Clinicopathological features of carcinosarcoma in oromaxillofacial head and neck region

HE Hai-lei¹, LIU Zhong-long², MA Chun-yue², LI Xiao-guang², HE Yue²

1.Department of Stomatology. Ganzhou People's Hospital. Ganzhou 341000, Jiangxi Province;
2.Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China

Received:2017-01-12 Revised:2017-05-16 Online:2017-10-25 Published:2017-11-23

摘要/Abstract

摘要： 目的探讨口腔颌面-头颈部癌肉瘤（carcinosarcoma）的临床特征、病理特征、治疗方法及预后。方法对上海交通大学医学院附属第九人民医院收集的10例口腔颌面-头颈部癌肉瘤患者的临床及病理资料进行分析,包括临床表现、影像学表现、病理表现、治疗及愈后等方面。结果10例患者中,男8例,女2例;年龄20~81岁,平均44岁（中位年龄45.5岁）。肿瘤大小不一,直径在1.5 cm以上,与发生部位有关。临床表现多为异物感或迅速增大的肿物,甚至疼痛不适。病理证实含癌及肉瘤样间质,为癌肉瘤。临床上主要与鳞癌相鉴别,确诊取决于术后病理检查尤其是免疫组织化学分析。鳞状细胞癌为上皮样组织的恶性肿瘤,而癌肉瘤则兼有上皮样组织及间叶样组织。预后较差,5年生存率50%。结论癌肉瘤确诊依赖于术后病理学检查,手术完整切除+血管化皮瓣修复+术后放疗为常规治疗方法,根据实际情况予以化疗。

关键词: 口腔颌面-头颈部, 癌肉瘤, 临床病理特征

Abstract: PURPOSE: To analyze the clinical features, histopathological features, treatment and prognosis of carcinosarcoma in oromaxillofacial head and neck region. METHODS: The clinical and histopathological data of 10 cases with carcinosarama were collected from database of Shanghai Ninth People's Hospital and further analyzed. RESULTS: A total of 10 cases (8 males and 2 females) of carcinosarcoma were collected and analyzed. The age of patients ranged from 20 to 81 years (mean: 44, median:45.5). The tumor size was related to the primary site. The main clinical manifestations indicated rapid increase of foreign body sensation or mass, even feeling of pain. Pathologic examination confirmed the presence of carcinoma and sarcomatoid stroma. Carcinosarcoma had low incidence and was easily misdiagnosed. Diagnosis depended on pathologic examination especially immunohistochemistry. The prognosis was poor, and 5 year survival rate was 50%. CONCLUSIONS: Diagnosis to carcinosarcoma depends on pathological examination after operation. Complete resection + free flap transplantation + postoperative radiotherapy and chemotherapy are conventional treatment.

Key words: Oromaxillofacial head and neck region, Carcinosarcoma, Clinicopathological features

中图分类号:

R739.8

何海蕾, 刘忠龙, 马春跃, 李晓光, 何悦. 口腔颌面-头颈部癌肉瘤10例临床分析[J]. 上海口腔医学, 2017, 26(5): 569-572.

HE Hai-lei, LIU Zhong-long, MA Chun-yue, LI Xiao-guang, HE Yue. Clinicopathological features of carcinosarcoma in oromaxillofacial head and neck region[J]. Shanghai Journal of Stomatology, 2017, 26(5): 569-572.

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口腔颌面-头颈部癌肉瘤10例临床分析

Clinicopathological features of carcinosarcoma in oromaxillofacial head and neck region

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