鼻副鼻腔再発上咽頭癌に対して内視鏡下切除術を行った1症例

Abstract

Surgical indications for nasopharyngeal carcinoma are limited, and dealing with recurrent cases is often challenging. We experienced a case of nasopharyngeal cancer recurrence in the nasal sinuses after chemoradiotherapy, in which the lesion was completely removed by two transnasal endoscopic procedures. The patient was a 50-year-old man. He was diagnosed with T2N2M0 nasopharyngeal carcinoma on the left posteriosuperior wall and was treated by chemoradiotherapy with CDDP. Nine months after the treatment, a grossly recurrent lesion was found in the left nasal cavity. Since no intracranial or intraorbital extension was observed, the lesion was considered resectable and a transnasal endoscopic surgery was performed.Four months after the surgery, a small recurrent lesion was found, and an additional endoscopic resection was performed. Surgical margins of the specimen from the additional resection were negative, and no recurrence was observed for 18 months after the second surgery. Neither cranial or orbital complication was experienced, and minimally invasive treatments were achieved.