Squamous cell carcinoma of the right retromolar region, probably stage cT4bN2cM0, s/p induction chemotherapy. 2. Squamous cell carcinoma of right lower gingiva s/p operation and radiotherapy at TSGH(in 2010).
S: The patient was consulted for radiotherapy due to second SCC of right retromolar area with bone invasion s/p induction chemotherapy.
PI: This 62 year-old male patient had personal history of smoking for 20+ years, quit of betel nut chewing and drink wine about 4 years. He had SCC of right lower gingiva s/p OP and RT(2010) at TSGH. Then he was followed by in TSGH. He had second SCC of right retromolar area with bone invasion. He received induction chemotherapy with TPF since 2014/02/27~2014/05/08. His treatment plan was induction chemotherapy followed by surgery. Recently, he refused surgical treatment. Thus he was consulted for further evaluation and suggestion.
Previous RT Hx (+): at TSGH in 2010.
O: neck and bif SCF: s/p flap reconstruction over right facial area, surgical scars of right neck dissection; oral cavity (by NP scopy due to trismus): suspicious tumor over right retromolar-buccal area.
Pathology (S2014-01508, 2014-02-06): oral cavity, right retromolar, biopsy---squamous cell carcinoma.
CXR(2014-02-XX):Unremarkable of costophrenic angles and diaphgram. Port-A catheter insertento(這單字有錯) SVC via left subclavian vein.
MRI, Nasopharynx (2014-02-26):1. An infiltrative mass lesion in the right retromolar, region with invasion to the right masticator space and right maxillary bone. 2.enlarged and necrotic lymph nodes in the left carotid space. 3. Unremarkable change in the skull base. Imp: recurrent tumor in the right retromolar region. 2.post-OP change in the right upper neck and right face.
Bone scan (2014-02-26): 1. A hot spot in the right aspect of the maxilla, the nature is to be determined dental problem, early bone mets or other nature?
Echo for abdomen(2014-02-27): negative finding.
- 鴕鳥Lv 56 年前最佳解答