以延髓麻痹为主要表现的舌根部鳞癌伴颈部淋巴结转移1例  

Squamous cell carcinoma of the tongue base with cervical lymph node metastasis presenting with bulbar palsy:a case report.

作　　者：罗雅尹 宋凡[1] 梁战华[1] 宋春莉[1] LUO Yayin;SONG Fan;LIANG Zhanhua;SONG Chunli(Department of Neurology,The First Affiliated Hospital of Dalian Medical University,Dalian 116011,China.)

机构地区：[1]大连医科大学附属第一医院神经内科,大连116011

出　　处：《中国神经精神疾病杂志》2022年第3期148-150,共3页Chinese Journal of Nervous and Mental Diseases

摘　　要：球部起病的肌萎缩侧索硬化需要与口咽部肿瘤鉴别。本文报告1例以延髓麻痹为主要表现的舌根部鳞癌伴颈部淋巴结转移患者的临床诊治过程,供临床医生借鉴。患者男,62岁,表现为逐渐加重的饮水呛咳、吞咽困难、构音障碍和伸舌无力,但是舌肌无萎缩、束颤,无强哭强笑。头颅核磁、肌电图、新斯的明试验未见明显异常。颈部和口咽部核磁示舌根部恶性肿瘤伴颈部淋巴结转移,舌活检病理证实为鳞状细胞癌。经介入动脉化疗栓塞治疗后,病灶较前缩小。Bulbar-onset amyotrophic lateral sclerosis needs to be differentiated from oropharyngeal tumors.A rare squamous cell carcinoma of the tongue base with cervical lymph node metastasis presenting with bulbar palsy patient was reported.A 62-year-old male presented with progressive dysphagia,dysarthria and weakness of the tongue without atrophy.Patient did not have any sign of fasciculation,forced crying or laughing.Brain MRI and electromyography showed no significant abnormalities,and neostigmine test was negative.Neck and oropharynx MRI showed a malignant tumor involving the base of the tongue with cervical lymph node metastasis,which was confirmed to be squamous cell carcinoma by tongue biopsy.After a percutaneous selective arterial chemoembolization,the tumor became smaller than before followup one month.

关 键 词：肌萎缩侧索硬化 延髓麻痹 肌电图 舌癌 舌麻痹 吞咽困难 构音障碍 

分 类 号：R747.9[医药卫生—神经病学与精神病学]