Metastatski tumori vrata bez poznatog primarnog sijela

master's thesis

• Title (english): Metastatic neck cancer with unknown primary site
• Author: Kristina Fabijanec
• Mentor: Mirko Ivkić (mentor)
• Committee member: Vladimir Bedeković (predsjednik povjerenstva)
• Committee member: Drago Prgomet (član povjerenstva)
• Committee member: Mirko Ivkić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Othorhinolaryngology and Head and Neck Surgery); Zagreb
• Defense date and country: 2015-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Otorhinolaryngology
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Oncology

Abstract

Cilj ovog diplomskog rada bio je pobliže obraditi problematiku jedne manje, ali specifične skupine među malignomima, koja se karakteristično javlja u određenim rizičnim grupama, vezano prije svega uz abuzus alkohola i duhana, te recentnije uz HPV infekcije. Klinički se prezentiraju metastatskim limfnim čvorom na vratu, a histološki se u najvećem broju slučajeva radi o planocelularnom karcinomu. Značajan problem u samom dijagnostičkom postupku je relativno kasno prepoznavanje maligne prirode problema i često liječenje ponavljanim antibiotskim terapijama u primarnoj zdravstvenoj zaštiti, s posljedičnim vremenskim gubitkom i do tri mjeseca prije pregleda specijalista za kirurgiju glave i vrata. Daljnja obrada pacijenta usmjerena je identifikaciji i lokalizaciji primarnog sijela tumora koji je generirao metastatsku masu na vratu, a uključuje kliničke, citološko-histološke, slikovne radiološke i endoskopske metode. No, kako i sam naslov rada govori, primarni se tumor nikada ne otkriva, te se kirurško liječenje, kao osnova terapije, provodi u vidu kurativne disekcije vrata, čija opsežnost ovisi o stadiju metastaze i regiji vrata u kojoj se prezentirala. Kombinacija opsežnog kirurškog zahvata i adjuvantne radioterapije rezultira petogodišnjim preživljenjem u minimalno 60% slučajeva. No, prema dostupnim podatcima, 55% liječenih pacijenata u kasnijem tijeku ipak razvije primarni tumor, što je zapravo vječito otvorena mogućnost i strepnja u liječenju ove skupine pacijenata.

Abstract (english)

The aim of this thesis was to process one smaller but specific percentage of malignant tumors, that characteristically appear at particular vulnerable groups, especially with alcohol and drug abuse, and recently with HPV infections. Clinical presentation is metastatic lymph node in the neck, and in most cases histology reveals squamous cell carcinoma. A significant problem of patient workup is late recognition of it's malignant nature and oftentimes repeated antibiotic treatment, and as a result of it a time waste up to three months. Further workup is focused on the identification and localisation of the primary site, and includes clinical, cytological and hystological methods, radiological imaging, and endoscopy. As the term itself reveals, the origin of the metastasis is never found, so the surgical treatment, which is essential and means curative neck dissection, depends on the metastasis stage and the affected neck region. The combination of extensive surgical treatment and adjuvant radiotherapy results in five-year survival rate up to 60%. However, approximately 55% of treated patients develop primary tumor, and represent greatest anxiety and always an open possibility.

• Keywords: metastatski limfni čvor; planocelularni karcinom; primarno sijelo; kurativna disekcija
• Keywords (english): metastatic lymph node; squamous cell carcinoma; primary site; curative neck dissection
• Language: croatian
• URN:NBN: urn:nbn:hr:105:700895
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2016-04-07 09:28:38