舌癌術後の縦隔リンパ節転移による気管狭窄に対して気道ステントを使用した1例

• Published in: 日本口腔外科学会雑誌 Vol. 65; no. 2; pp. 67 - 71
• Main Authors: 鈴木, 慎太郎, 森下, 佳学, 畔柳, 豪, 長谷川, 正午, 神道, 紀衣
• Format: Journal Article
• Language: Japanese
• Published: 社団法人 日本口腔外科学会 20.02.2019
• Subjects: 気管気管支狭窄; 気道ステント; 縦隔リンパ節転移; 頭頸部癌
• ISSN: 0021-5163; 2186-1579
• DOI: 10.5794/jjoms.65.67

Airway stents are used to improve dyspnea caused by obstructive/stenotic tracheobronchial lesions. Tracheobronchial stenosis caused by a malignant tumor is found in tracheal, lung, esophageal and thyroid cancer. We report on a patient in whom an airway stent was used to treat tracheal stenosis caused by delayed mediastinal lymph node metastasis of tongue cancer.　The patient was a 47-year-old-woman who was referred to our hospital for close examination and treatment of a tongue cancer. A clinical diagnosis of left tongue cancer (cT4aN0M0) was made, and we performed a left radical neck dissection, right super-selective neck dissection (level I), subtotal glossectomy, tracheotomy, and reconstructive surgery using a rectus abdominis free flap. A computed tomographic examination 12 months after surgery revealed metastasis to a superior mediastinal lymph node. The metastatic lymph node expanded, and the patient started to present with severe dyspnea due to the development of tracheal stenosis. We therefore placed an airway stent into the trachea. Airway stenting relieved symptoms of severe dyspnea, and we administered TPF chemotherapy, but it was not effective. The tracheal stent we applied enabled the patient to prolong her life for approximately 4 months before she died of the cancer.