Respiratory Distress Secondary to Rhabdomyosarcoma of the Tongue and Co-existent Choanal Atresia
Respiratory Distress Secondary to Rhabdomyosarcoma of the Tongue and Co-existent Choanal Atresia
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DOI：
10.1007/s12663-015-0772-7
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发表时间：
2016-07-01
影响因子：
0.9
通讯作者：
Pandey, Vaibhav
中科院分区：
文献类型：
--
作者：
Chatopadhayay, Rahul;Tiwari, Preeti;Pandey, Vaibhav
虽然横纹肌肉瘤（RMS）是儿童中第三常见的实体瘤，但舌的先天性RMS极其罕见，并且通常自出生以来表现为无痛进行性肿块（Dagher和Helman in Oncologist 4：34-44，1999;查尔兹和Goudy in Int J Pediatr Otorhinolaryngol 5：126-128，2010）。在新生儿中，由于新生儿偏好鼻呼吸，并且由于肿瘤导致的经口呼吸受限通常不会造成问题，因此呼吸窘迫的表现是意外的。我们在此报告一个舌横纹肌肉瘤合并单侧后鼻孔闭锁的病例，表现为呼吸窘迫。婴儿出现上呼吸道感染，随后出现严重呼吸窘迫。由于感染或腺样体肥大和单侧胆管闭锁引起的双鼻孔阻塞，导致气道症状加重。在RMS和双侧鼻病变存在的情况下治疗呼吸窘迫必须首先优先考虑气道的安全性，然后才采取多因素方法治疗舌肿块（查尔兹和Goudy in Int J Pediatr Otorhinolaryngol 5：126-128，2010）。本病例说明了警惕共存的鼻腔病变的重要性，以避免发生完全的气道阻塞。因此，我们认为任何舌RMS的诊断都应该对两个鼻腔进行正式检查。
Whilst rhabdomyosarcoma (RMS) is the third most common solid tumour in children, congenital RMS of the tongue is extremely rare and usually present as painless progressive mass since birth (Dagher and Helman in Oncologist 4:34-44, 1999; Childs and Goudy in Int J Pediatr Otorhinolaryngol 5:126-128, 2010). In neonates, presentation with respiratory distress is unexpected as neonates are preferential nasal breathers and restricted oral breathing due to tumour usually poses no problem. We herein report a case of rhabdomyosarcoma of the tongue with co-existent unilateral choanal atresia, presenting with respiratory distress. The baby developed upper respiratory tract infection following which developed severe respiratory distress. Airway symptoms were precipitated as there was combined obstruction of both the nostrils due to infection or adenoid enlargement and unilateral chonal atresia. Treatment of respiratory distress in the presence of RMS and bilateral nasal pathology must first prioritise the security of the airway, before taking a multi-factorial approach to the therapy of the lingual mass (Childs and Goudy in Int J Pediatr Otorhinolaryngol 5:126-128, 2010). This case illustrates the importance of vigilance with respect to coexistent nasal pathology, in order to avoid the occurrence of complete airway obstruction. We therefore feel that any diagnosis of lingual RMS should warrant a formal examination of both nasal cavities.