喉頭癌か下咽頭癌か鑑別診断に苦慮した症例の検討

抄録

In advanced carcinoma of the larynx or hypopharynx, it is not easy to distinguish the primary site of the lesion. Six cases of advanced squamous cell carcinoma of the larnx or hypopharynx, treated at Metropolitan Komagome Hospital from 1982 to 1984, were retrospectively studied. All patients were males, and ages ranged from 50 to 83 years (mean age 69 years). Two of the six patients were classified as stage III, four as stage IV. Two were treated by surgery, three by radiation therapy, and one by a combination of the two. A hypopharyngogram, laryngogram, and computed tomography were useful to estimate the extent of the lesion, but were not valuable in distinguishing the origin of the tumor. Endoscopy was not helpful because the carcinomas were too advanced to observe both the hypopharynx and the larynx precisely. Finally, three cases were diagnosed as supraglottic and three as pyriform sinus carcinomas, based on observations of surgically excised specimens, or of tumor regression after radiation therapy. For differentiating advanced laryngeal carcinoma from the hypopharyngeal carcinoma at pretreatment, more useful methods and implements are necessary.