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首页> 外文期刊>Cancers of the head & neck. >An unusual case of tracheo-pleural fistula and cardiac metastases in oropharyngeal carcinoma: a case report and review of the literature
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An unusual case of tracheo-pleural fistula and cardiac metastases in oropharyngeal carcinoma: a case report and review of the literature

机译：口咽癌的气管胸膜瘘和心脏转移的不寻常病例：一例并文献复习

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Background Oropharyngeal cancer is frequently associated with human papilloma virus, that also represents a strong prognostic factor. Local relaps and treatment-related complications are frequent, whereas distant metastases occur in about 25% of patients. Case presentation A 49?years-old male presented with a loco-regionally advanced oropharyngeal squamous cell carcinoma and was treated with concomitant chemoradiation. A complete clinical and pathological response was achieved, but the occurrence of necrotising tracheo-esophagitis, with tracheo-mediastino-pleural fistula formation, further complicated the subsequent clinical course. The patient died suddenly. Autopsy revealed multiple myocardial and epicardial metastases from oropharyngeal squamous cell carcinoma. Conclusions Even in case of a transient complete local response, the potential occurrence of severe complications and distant metastases, although infrequent, should be considered. Cardiac metastases are frequently underestimated, as they are often asymptomatic, but may lead to sudden death. Further efforts are needed to improve diagnosis and therapy in this setting.
机译：背景口咽癌经常与人乳头瘤病毒有关，这也代表了强大的预后因素。局部复发和与治疗有关的并发症很常见，而远处转移发生在约25％的患者中。病例介绍一名49岁男性，患有局部区域晚期口咽鳞状细胞癌，并接受了化学放疗。达到了完全的临床和病理学反应，但是坏死性气管食管炎的发生，伴有气管中纵肌胸膜瘘的形成，进一步使随后的临床过程复杂化。病人突然死亡。尸检显示来自口咽鳞状细胞癌的多个心肌和心外膜转移。结论即使在短暂的完全局部反应的情况下，也应考虑潜在的严重并发症和远处转移的发生，尽管并不常见。心脏转移瘤通常无症状，因此经常被低估，但可能导致猝死。在这种情况下，需要进一步的努力来改善诊断和治疗。

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