Name: 連xx chart No.: 300xxxx Age: 48 Sex : M



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Tumor Board

2003-164 09-15



Name: XX Chart No.: 300xxxx Age: 48 Sex : M

Diagnosis: Tongue CA S/P OP (initial stage: T4aN2cMo) with bone metastasis

91-06

Smoking: 15PPD quit for 15yrs

Betel nut: 10# QD quit for 12 yrs

Right oral ulcer


91-12

Went to KMUH and biopsy showed SCC

Came to our OPD and admitted on 12/24

MRI: mass over right hemi tongue, bilateral submandibular and carotid space lymph node


91-12-25

Total glossectomy, right MRND(type II), left SND(I, II, III), reconstruction with forearm flap

Pathology(S0230683): Right lymph node (4/30)



92-2~3

CCRT

92-08

Right shoulder and back pain

92-09

X-Ray: osteolytic lesion over left shoulder

Imaging: to be presented

Imaging:

MRI:


  1. Tumor at right side of tongue with crossing midline

  2. Bilateral LAP(+)

X-ray: osteolytic lesion of left shoulder

討論

Asp婁:此病例stage 是T3, 因為沒有involve mouth floor

Dr. 丁:需配合Bone Scan來看(註: Bone Scan報告Multifocal hot areas in the mid portion of right femur, left scapular, left humoral head and a geographic halo rim in the right lat. skull were noted. )

Asp婁: Tongue cancer大都是lung meta. 很少bone meta.

P. 徐:

1.病人有low back pain 會不有lumber spine meta.



2.至少需做biopsy

Asp婁:


  1. 可做palliative C/T and local R/T

  2. CT-guided FNA 以證實同一疾病

Dr. 丁:贊成


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