Abstract
We experienced a case of maxillary carcinoma in which pancytopenia occurred after concurrent chemoradiotherapy (CCRT). The patient was a 68-year-old man. He had complained of right cheek pain one and a half months previously, and consulted a nearby otolaryngologist. CT imaging of the paranasal sinus demonstrated an abnormal shadow with bone destruction of the right maxillary sinus anterior wall. The patient was suspected as having maxillary cancer and was referred to our hospital. PET showed high accumulation in the right maxillary sinus and the lesion was diagnosed as a maxillary carcinoma (squamous cell carcinoma, T2N0M0, Stage II) by biopsy under local anesthesia. The patient underwent CCRT using 80 mg/m2 of carboplatin (CBDCA). However, combination therapy with CBDCA was stopped after seven times administration since platelet marker decreased to 28,000. Radiation alone treatment was subsequently continued to 70 Gy. On the day after completing radiation, the patient was diagnosed as having pancytopenia and he also suffered from Methicillin-resistand Staphylococcus auerus infection-mediated pneumonia, pharyngitis, and sinusitis. After three months of intensive treatment, he had almost recovered. However, CT and PET imaging showed multiple metastasis and he died two months later.
