内容紹介
A Case of Cervical Lymph Node Metastasis from an Unknown Primary Cancer Controlled with Immunotherapy, Chemotherapy, and Surgery
Summary
We present a case of cervical lymph node metastasis from an unknown primary cancer that was controlled with immunotherapy, chemotherapy, and surgery. The patient, a 61-year-old man, was referred to our department for treatment of a lesion in the left cervical lateral area. At the initial visit, the mass was covered by reddened skin and was elastic, hard, and immobile on palpation. The presence of a malignant disease such as malignant lymphoma or lymphadenitis because of infection by tubercle bacillus or Epstein-Barr virus was suspected on the basis of the clinical and magnetic resonance imaging findings. Biopsy and resection of the cervical mass was performed under general anesthesia. Because the pathological diagnosis during surgery indicated squamous cell carcinoma, the surgical approach was changed to neck dissection. Head, neck, and thoracic computed tomography and other examinations were performed to locate the primary cancer, but its origin remained unknown. Postoperative therapy consisted of chemotherapy and immunotherapy. The patient has been followed up for 4 years and 10 months without any evidence of recurrence.
要旨
われわれは,切除と免疫・化学療法にて制御し得た61歳,男性の原発不明頸部リンパ節転移癌の1例を経験したので報告する。患者は側頸部の腫脹を主訴に当科受診された。初診時,左側頸部に弾性硬,皮膚の発赤を伴った非可動性の腫瘤を認めた。臨床所見やMRの結果,悪性リンパ腫,結核性リンパ節炎,EBウイルスによる感染が疑われた。全身麻酔下に腫瘤切除・生検術を施行したが,術中迅速病理検査にて扁平上皮癌と判明し,頸部郭清術に術式を変更し手術を施行した。術後,頭頸部・頬部CT,その他検査を施行したが,原発巣は判明できなかった。術後療法として,抗癌剤による化学療法・免疫療法を施行した。術後4年10か月が経過しているが,再発もなく術後経過良好である。
目次
Summary
We present a case of cervical lymph node metastasis from an unknown primary cancer that was controlled with immunotherapy, chemotherapy, and surgery. The patient, a 61-year-old man, was referred to our department for treatment of a lesion in the left cervical lateral area. At the initial visit, the mass was covered by reddened skin and was elastic, hard, and immobile on palpation. The presence of a malignant disease such as malignant lymphoma or lymphadenitis because of infection by tubercle bacillus or Epstein-Barr virus was suspected on the basis of the clinical and magnetic resonance imaging findings. Biopsy and resection of the cervical mass was performed under general anesthesia. Because the pathological diagnosis during surgery indicated squamous cell carcinoma, the surgical approach was changed to neck dissection. Head, neck, and thoracic computed tomography and other examinations were performed to locate the primary cancer, but its origin remained unknown. Postoperative therapy consisted of chemotherapy and immunotherapy. The patient has been followed up for 4 years and 10 months without any evidence of recurrence.
要旨
われわれは,切除と免疫・化学療法にて制御し得た61歳,男性の原発不明頸部リンパ節転移癌の1例を経験したので報告する。患者は側頸部の腫脹を主訴に当科受診された。初診時,左側頸部に弾性硬,皮膚の発赤を伴った非可動性の腫瘤を認めた。臨床所見やMRの結果,悪性リンパ腫,結核性リンパ節炎,EBウイルスによる感染が疑われた。全身麻酔下に腫瘤切除・生検術を施行したが,術中迅速病理検査にて扁平上皮癌と判明し,頸部郭清術に術式を変更し手術を施行した。術後,頭頸部・頬部CT,その他検査を施行したが,原発巣は判明できなかった。術後療法として,抗癌剤による化学療法・免疫療法を施行した。術後4年10か月が経過しているが,再発もなく術後経過良好である。