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ENT  R1   許朝淵 VS Ken Liao Liu  劉耿僚 六月光田腫瘤聯合討論 Tumor Board Otolaryngology-Head & Neck Surgery , KTGH, Taiwan
Basic data <ul><li>Name: 李 x 全 </li></ul><ul><li>Age/Sex: 45/Male </li></ul><ul><li>Address: 台中沙鹿 </li></ul><ul><li>Marita...
Basic data <ul><li>Cigarette smoking : 4 PPD for 20 years.  </li></ul><ul><li>Betel nuts : sometimes.  </li></ul><ul><li>A...
Past history <ul><li>Hypopharyngeal cancer (cT3N1M0) s/p total laryngectomy  </li></ul><ul><li>Esophageal cancer (cT1N0M0)...
Intra-op: Into Laryngopharynx 2008-11-20
Specimen : Total laryngopharyngectomy
After Total Laryngopharyngectomy Esophagus (cut end) Oropharynx (cut end)
Gastric Pull-up Reconstruction Gastric pull-up anastomosis with oropharynx
Past history <ul><li>RT dose----4500cGy/25fx to  </li></ul><ul><li>tumor bed and lower neck since Dec.17,2008 ~ Jan.20,200...
Patient history Excisional biopsy : Metastatic SCC Salvage RT   PET/CT: 2.4x2.7x2.3 cm at the mediastinum. PET/CT: mediast...
2010-06-18
Head & Neck :  No finding
 
 
Patient history Salvage CCRT  RTdose:5400cGy/30fx C/T: cisplatin + 5-FU  subcarinal, biopsy :  Metastatic SCC 2010/09/17  ...
2010-10-22 Posterior neck mass: excision pathology: benign
Patient history <ul><li>2010/12/31 ENT OPD </li></ul><ul><li>C.C.:Chest wall pain with mild dyspnea for days. </li></ul><u...
Patient history <ul><li>2011/01/03 CHEST CT: </li></ul><ul><li>----A fistula formation noted between left  main bronchus a...
Patient history <ul><li>2011/01/04 bronchus, biopsy : </li></ul><ul><li>Inflammatory exudate and fibrous tissue, consisten...
Patient history <ul><li>2011/01/06 :  </li></ul><ul><li>Endoesophageal intubation with stent of  </li></ul><ul><li>T-E fis...
Patient history <ul><li>2011/03/02 Chest CT : </li></ul><ul><li>4 x 2 cm mass  in right side of the gastric tube, from abo...
Thanks for your attention~!
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Tumor board hypopharyngeal ca - dr ken liao liu

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Hypopharyngeal carcinoma post total laryngectomy with gastric pull-up reconstruction. T-E fistula , medistinal LN metastasis.

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Tumor board hypopharyngeal ca - dr ken liao liu

  1. 1. ENT R1 許朝淵 VS Ken Liao Liu 劉耿僚 六月光田腫瘤聯合討論 Tumor Board Otolaryngology-Head & Neck Surgery , KTGH, Taiwan
  2. 2. Basic data <ul><li>Name: 李 x 全 </li></ul><ul><li>Age/Sex: 45/Male </li></ul><ul><li>Address: 台中沙鹿 </li></ul><ul><li>Marital status: Married. </li></ul><ul><li>Occupation : None. </li></ul><ul><li>ECOG : 0 </li></ul>
  3. 3. Basic data <ul><li>Cigarette smoking : 4 PPD for 20 years. </li></ul><ul><li>Betel nuts : sometimes. </li></ul><ul><li>Alcohol : sometimes </li></ul>
  4. 4. Past history <ul><li>Hypopharyngeal cancer (cT3N1M0) s/p total laryngectomy </li></ul><ul><li>Esophageal cancer (cT1N0M0) s/p total esophagectomy, with pulled-up gastric tube reconstruction on Nov.20,2008. </li></ul>
  5. 5. Intra-op: Into Laryngopharynx 2008-11-20
  6. 6. Specimen : Total laryngopharyngectomy
  7. 7. After Total Laryngopharyngectomy Esophagus (cut end) Oropharynx (cut end)
  8. 8. Gastric Pull-up Reconstruction Gastric pull-up anastomosis with oropharynx
  9. 9. Past history <ul><li>RT dose----4500cGy/25fx to </li></ul><ul><li>tumor bed and lower neck since Dec.17,2008 ~ Jan.20,2009. </li></ul>
  10. 10. Patient history Excisional biopsy : Metastatic SCC Salvage RT PET/CT: 2.4x2.7x2.3 cm at the mediastinum. PET/CT: mediastinum mass 2009/07/01 2009/07/14 2009/08/05 ~ 2009/09/08 2010/09/01
  11. 11. 2010-06-18
  12. 12. Head & Neck : No finding
  13. 15. Patient history Salvage CCRT RTdose:5400cGy/30fx C/T: cisplatin + 5-FU subcarinal, biopsy : Metastatic SCC 2010/09/17 2010/10/04 ~ 2010/12/24
  14. 16. 2010-10-22 Posterior neck mass: excision pathology: benign
  15. 17. Patient history <ul><li>2010/12/31 ENT OPD </li></ul><ul><li>C.C.:Chest wall pain with mild dyspnea for days. </li></ul><ul><li>Fiberscope: susp. T-E fistula </li></ul><ul><li> refer to CS OPD and admission </li></ul>
  16. 18. Patient history <ul><li>2011/01/03 CHEST CT: </li></ul><ul><li>----A fistula formation noted between left main bronchus and the gastric tube noted. </li></ul><ul><li>----left lower lung aspiration pneumonia. </li></ul><ul><li>----Suspicious residual tumor in right side of carinal region. </li></ul>
  17. 19. Patient history <ul><li>2011/01/04 bronchus, biopsy : </li></ul><ul><li>Inflammatory exudate and fibrous tissue, consistent with fistula </li></ul>
  18. 20. Patient history <ul><li>2011/01/06 : </li></ul><ul><li>Endoesophageal intubation with stent of </li></ul><ul><li>T-E fistula </li></ul>
  19. 21. Patient history <ul><li>2011/03/02 Chest CT : </li></ul><ul><li>4 x 2 cm mass in right side of the gastric tube, from above carina level to below carina level, consistent with residual tumor. </li></ul>
  20. 22. Thanks for your attention~!

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