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摘要: 神经内分泌癌(NEC)是一种来源于神经内分泌细胞的恶性肿瘤,具有明确的临床、形态学和免疫组织化学特征,头颈部NEC在临床上很少见,喉是最常见的受累部位,舌根极为罕见。临床表现主要为进食疼痛、口腔内菜花样肿物、长久不愈合的溃疡性病变等。颌面部MRI和增强CT检查是此类疾病最常用的检查手段,可以发现肿瘤的占位性病变;病理光镜下胞质中发现神经内分泌颗粒可以诊断为NEC;但对于大多数病例,仅光镜下难以确诊,常需借助免疫组织化学染色等技术手段来确诊。本文报道1例舌根部NEC,介绍其病例特点和诊治经过,并对该病例进行相关文献复习。Abstract: Neuroendocrine carcinoma(NEC) is a malignant tumor derived from neuroendocrine cells, with distinct clinical, morphological and immunohistochemical characteristics. Neuroendocrine carcinoma of the head and neck is very rare in clinic. Larynx is the most common affected site, and the root of the tongue is extremely rare. The clinical manifestations are mainly eating pain, cauliflower like mass in the mouth, and ulcerative lesions that have not healed for a long time. Maxillofacial MRI and contrast-enhanced CT are the most commonly used examination tools for such diseases, which can detect the space-occupying lesions of tumors. Neuroendocrine granules found in the cytoplasm under pathological light microscope can be diagnosed as neuroendocrine carcinoma. However, for most cases, it is difficult to make a diagnosis only under light microscope, and it is often necessary to make a diagnosis by means of immunohistochemistry and other technical means. This paper reports a case of neuroendocrine carcinoma of the root of the tongue, introduces its characteristics, diagnosis and treatment, and reviews the relevant literature of this case.
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Key words:
- neuroendocrine carcinoma /
- tongue /
- head and neck region /
- case reoport
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[1] Chernock RD, Duncavage EJ. Proceedings of the NASHNP Companion Meeting, March 18th, 2018, Vancouver, BC, Canada: Salivary Neuroendocrine Carcinoma-An Overview of a Rare Disease with an Emphasis on Determining Tumor Origin[J]. Head Neck Pathol, 2018, 12(1): 13-21. doi: 10.1007/s12105-018-0896-4
[2] Kusafuka K, Asano R, Kamijo T, et al. Large cell neuroendocrine carcinoma of the tongue base: case report of an unusual location with immunohistochemical analysis[J]. Int J Oral Maxillofac Surg, 2009, 38(3): 296-299. doi: 10.1016/j.ijom.2008.12.012
[3] Zeng M, Yang SD, Zhang JL, et al. Primary small cell neuroendocrine carcinoma of the oral cavity: A case report and review of the literature[J]. Oncol Lett, 2015, 10(2): 887-890. doi: 10.3892/ol.2015.3298
[4] Mills SE. Neuroectodermal neoplasms of the head and neck with emphasis on neuroendocrine carcinomas[J]. Mod Pathol, 2002, 15(3): 264-278. doi: 10.1038/modpathol.3880522
[5] 尹建枚, 王鑫启, 傅仲鹰, 等. 喉小细胞神经内分泌癌1例[J]. 临床耳鼻咽喉头颈外科杂志, 2020, 34(7): 655-657. doi: 10.13201/j.issn.2096-7993.2020.07.019 https://lceh.whuhzzs.com/article/doi/10.13201/j.issn.2096-7993.2020.07.019
[6] 冯小琼, 邵贝贝. 颌面部神经内分泌癌的研究进展[J]. 河南医学研究, 2020, 10(7): 3-4. https://www.cnki.com.cn/Article/CJFDTOTAL-HNYX202007103.htm
[7] 袁璇, 谢志海, 章华, 等. 鼻及颅底神经内分泌癌的临床特征及内镜手术切除疗效分析[J]. 临床耳鼻咽喉头颈外科杂志, 2021, 35(8): 740-745. doi: 10.13201/j.issn.2096-7993.2021.08.014 https://lceh.whuhzzs.com/article/doi/10.13201/j.issn.2096-7993.2021.08.014
[8] Prabhu S, Smitha RS, Punnya VA. Merkel cell carcinoma of the alveolar mucosa in a young adult: a rare case report[J]. Br J Oral Maxillofac Surg, 2010, 48(1): 48-50. doi: 10.1016/j.bjoms.2008.12.005
[9] 邱梦君, 熊枝繁, 孙文佳, 等. 神经内分泌癌的临床特点[J]. 山东医药, 2018, 58(11): 64-66. doi: 10.3969/j.issn.1002-266X.2018.11.019
[10] Duan K, Mete O. Algorithmic approach to neuroendocrine tumors in targeted biopsies: Practical applications of immunohistochemical markers[J]. Cancer Cytopathol, 2016, 124(12): 871-884. doi: 10.1002/cncy.21765
[11] 郑国峰, 应红芳, 周水洪. 头颈部神经内分泌癌[J]. 中华耳鼻咽喉头颈外科杂志, 2015, 50(3): 260-264. doi: 10.3760/cma.j.issn.1673-0860.2015.03.021
[12] Kauhanen S, Seppänen M, Ovaska J, et al. The clinical value of[18F]fluoro-dihydroxyphenylalanine positron emission tomography in primary diagnosis, staging, and restaging of neuroendocrine tumors[J]. Endocr Relat Cancer, 2009, 16(1): 255-265. doi: 10.1677/ERC-08-0229
[13] Cymerman JA, Kulkarni R, Gouldesbrough D, et al. Small cell neuroendocrine tumour of the anterior tongue: A case report[J]. Int J Surg Case Rep, 2013, 4(8): 753-755. doi: 10.1016/j.ijscr.2013.04.028
[14] Sugawara C, Takahashi A, Kawano F, et al. Neuroendocrine tumor in the mandible: a case report with imaging and histopathologic findings[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2015, 119(1): e41-48. doi: 10.1016/j.oooo.2014.09.024
[15] Esmati E, Babaei M, Matini A, et al. Neuroendocrine carcinoma of the tongue[J]. J Cancer Res Ther, 2015, 11(3): 659-659.
[16] 彭金林, 李笑秋, 刘柱, 等. 31例鼻腔鼻窦神经内分泌癌临床分析[J]. 临床耳鼻咽喉头颈外科杂志, 2022, 36(1): 32-35. https://lceh.whuhzzs.com/article/doi/10.13201/j.issn.2096-7993.2022.01.007
[17] van der Laan TP, Plaat BE, van der Laan BF, et al. Clinical recommendations on the treatment of neuroendocrine carcinoma of the larynx: A meta-analysis of 436 reported cases[J]. Head Neck, 2015, 37(5): 707-715.