■症例から学ぶ
頸部腫瘤のみを訴えた中咽頭癌症例―頸部腫瘤に対する初期対応を考える
横島 一彦1,2, 中溝 宗永1,2, 八木 聰明1,2
1日本医科大学大学院医学研究科頭頸部・感覚器科学
2日本医科大学付属病院耳鼻咽喉科・頭頸部外科
Oropharyngeal Cancer: Report of Two Patients Complaining of Only a Neck Mass
Kazuhiko Yokoshima1,2, Munenaga Nakamizo1,2 and Toshiaki Yagi1,2
1Department of Head & Neck and Sensory Organ Science, Graduate School of Medicine, Nippon Medical School
2Department of Otorhinolaryngology, Nippon Medical School
A neck mass is one of the most common complaints. General physicians and general surgeons often examine patients complaining of a neck mass; however, they tend to ignore the possibility of metastasis of the head and neck cancer. We report on two patients with oropharyngeal cancer who complained of only a neck mass, and we show how to diagnose a neck mass effectively. Patient 1 was a 71-year-old woman with advanced oropharyngeal cancer who had complained of a neck mass for 6 months. Although primary oropharyngeal tumor can be diagnosed easily by examining the oropharynx, the mass was misdiagnosed. After a correct diagnosis was made, neck dissection was performed, and this was followed by chemoradiotherapy. Patient 2 was a 48-year-old man with advanced oropharyngeal cancer. The neck mass was thought to be caused by a malignancy, but no primary lesion was detected with computed tomography, magnetic resonance,or endoscopic examination of the esophagus. However, the correct diagnosis was made after the oropharynx was examined. This patient was then successfully treated with en-bloc resection.The most important point for general physicians when examining patients with a neck mass is to consider the possibility of metastasis of the head and neck cancers.
日医大医会誌 2008; 4(1), 32-35
Key words
neck mass, oropharyngeal cancer, neck metastasis, differential diagnosis, primary care
Correspondence to
Kazuhiko Yokoshima, Department of Otorhinolaryngology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8602, Japan
E-mail：kyok@nms.ac.jp
受付：2007年7月27日 受理：2007年9月8日 |
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