自然脫落之口咽部癌肉瘤──病例報告

Spontaneous Auto-amputation of An Oropharyngeal Carcinosarcoma- A Case Report

癌肉瘤（carcinosarcoma）是一種高惡性度的腫瘤，由惡性上皮成分及惡性間葉（mesenchyma）成分組成。比較常見的發生部位為上消化道或上呼吸道，罹病者以老年人居多。我們遇到一位68歲男性，主訴吞嚥困難及口腔出血數日。診察時發現約4公分大小，呈深黑色、球狀之腫塊從右側口咽部突出，數日後腫塊自然脫落。腫瘤約3公分大小，巨觀下表面粗糙略為不規則球形，並帶些微出血。經病理免疫組織化學染色檢查，最終診斷為癌肉瘤。電腦斷層檢查顯示無殘存腫瘤及頸部淋巴轉移，因患者考量自身狀況而婉拒接受化療，故僅予以口服ufur並持續追蹤，迄今14個月尚無復發現象。

Carcinosarcoma is a highly malignant tumor consisting of malignant epithelial and mesenchymal components. The more common parts of occurrence are the upper digestive tract or upper respiratory tract, and most of patients are elderly. We treated a 68-year-old man who complained of dysphagia and oral bleeding for several days. On examination, we found a dark black, globular mass about 4 cm protruding from the right oropharynx, and the lump spontaneous autoamputated after a few days. The tumor was about 3 cm in size, and the surface was rough with mild oozing. By immunohistochemistry staining, it was finally diagnosed as carcinosarcoma. Computed tomography showed no residual tumor nor neck lymphatic metastasis. Because the patient refused to receive intravenous chemotherapy, he only took oral UFUR, and there has been no recurrence for 14 months.