鼻腔恶性肿瘤伴乳腺转移的临床表现及预后  

The characteristics and prognosis of meteastases to the breast from nasal cavity tumors

作　　者：曲媛[1] 易俊林[1] 黄晓东[1] 王凯[1] 高黎[1] 

机构地区：[1]北京协和医学院中国医学科学院肿瘤医院放疗科

出　　处：《中华放射肿瘤学杂志》2014年第5期411-414,共4页Chinese Journal of Radiation Oncology

摘　　要：目的 探讨鼻腔恶性肿瘤乳腺转移的临床表现及预后特征.方法 搜集1999年1月至2011年12月本院收治的846鼻腔恶性肿瘤患者临床资料,对发生乳腺转移患者的临床特征性表现、诊断方法、病理特点及预后进行分析.结果 共6例女性患者出现乳腺转移,发生率占0.7％.年龄13～37岁,中位数25岁.鼻腔原发灶病理分型分别为横纹肌肉瘤为3例、嗅神经母细胞瘤3例.腺转移多为多灶病变,可伴有其他部位的远处转移.6例患者中5例原发灶接受66～ 72 Gy分30～ 33次根治性放疗,1例鼻腔横纹肌肉瘤患者原发灶放疗14 Gy分7次时乳腺转移先行局部切除后给予原发灶44 Gy姑息放疗.6例患者中5例接受乳腺手术治疗,1例嗅神经母细胞瘤患者因乳腺转移前已发现多发肺转移及骨转移故接受了6周期环磷酰胺＋阿霉素＋长春新碱化疗.出现乳腺转移后的中位生存期为12.7个月.结论 鼻腔肿瘤的年轻女性患者易出现乳腺转移,超声检查可以为乳腺转移的诊断提供有用的信息,鼻腔肿瘤患者一旦出现乳腺及其他部位远处转移预后差.Objective To detect the clinical features and prognostic factors of nasal cavity malignancy with breast metastasis.Methods 846 Patients with nasal cavity malignancy from January 1999 to December 2011 were enrolled,the clinical and pathological features,clinical diagnostic methods and prognostic factors for breast metastasis patients were analyzed.Results Six female cases （median age 25） were diagnosed with breast metastasis,including 3 rhabdomyosarcoma and 3 olfactory neuroblastoma; consisting 0.7% of the total 846 cases of primary nasal malignancy group.The metastasis were more likely to be multiple breast lesions with/without metastasis in other site.For the primary tumor,five patients received 66-72 Gy/30-33f of radical radiotherapy,one patient with rest rhabdomyosarcoma received 58 Gy of palliative radiation since breast metastasis was found after 14 Gy of radiation and breast mass resection were performed right after.For the breast metastasis,five of 6 patients received breast surgery,one patients with olfactory neuroblastoma received 6 cycles cyclophosphamide ＋ adriamycin ＋ vincristine chemotherapy.Median survival was 12.7 months.Conclusions For nasal cavity malignancy,breast metastasis more likely occur in younger female patients.Ultrasound may provide useful information in evaluating breast metastasis.Cases combined with metastasis except breast have unfavorable prognosis.

关 键 词：肿瘤转移 乳腺 鼻腔肿瘤/放射疗法 预后 

分 类 号：R739.62[医药卫生—肿瘤]