Artikel
Cervical lymph node metastasis as first clinical sign of an oropharyngeal signet ring cell adenocarcinoma
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Veröffentlicht: | 8. August 2007 |
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Gliederung
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Intracellular mucin-producing adenocarcinomas, so called signet ring cell adenocarcinomas (SRCA), are most commonly found in the stomach or lower GI-tract. They occur far less frequently at other locations such as prostate, pancreas, mammarian gland or within the oropharyngeal cavity.
We present the case of a patient who suffered from indolent cervical nodular tumour. Biopsy and histopathological workup showed parts of a poorly differentiated SRCA. Thorough staging revealed an extended tumour of the oropharynx as primary. The definitive surgical therapy consisted of a transoral tumour-resection with CO2-laser and bilateral neck dissection. Final classification was pT2 pN2c cM0 G3.
So far only few cases of oropharyngeal SRCAs have been published. These tumours turned out to be either metastases from gastric or lower gastrointestinal primaries, or if not of metastatic origin, had the small salivary glands as origin. In all published cases, as well as in our case, radical surgical resection was the first step of a curative therapy trial. In our case adjuvant radiotherapy is planned because of the advanced tumour stage. Because of small numbers of published cases, an evaluation of therapy effects and outcomes is barely possible at this time.