Laryngorhinootologie 2018; 97(06): 379-391
DOI: 10.1055/a-0592-7965
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Das Plattenepithelkarzinom des Naseneingangs – Eine Literaturübersicht

Squamous cell carcinoma of the nasal vestibule – Review of literature
Mario Koopmann
1   HNO-Praxis Dr. med. Mario Koopmann
,
Claudia Rudack
2   Universitätsklinikum Münster, Abteilung für Hals-Nasen-Ohrenheilkunde, Kopf-Halschirurgie
,
Daniel Weiss*
3   HNO-Praxis Dülmen
,
Markus Stenner*
2   Universitätsklinikum Münster, Abteilung für Hals-Nasen-Ohrenheilkunde, Kopf-Halschirurgie
› Author Affiliations
Further Information

Publication History

07/12/2017

03/12/2018

Publication Date:
11 June 2018 (online)

Zusammenfassung

Hintergrund Das Plattenepithelkarzinom des Naseneingangs (Vestibulum nasi) ist eine sehr seltene Tumorentität. In der Konsequenz herrscht bezüglich der Ätiologie, des Stagings und der notwendigen Therapie dieser Tumoren nach wie vor Uneinigkeit. Insbesondere die Mitbehandlung regionaler Lymphknotenstationen ist Gegenstand wissenschaftlicher Diskussionen.

Methode Alle via Pubmed gefundenen Artikel zum Thema wurden hinsichtlich folgender Themenschwerpunkte untersucht: Lymphatische Versorgung, Metastasierung, Inzidenz, Prognose, Risikofaktoren (Leder, Nickel, Nikotin, Humane Papillomaviren), Tumorklassifikationssystem (UICC-, AJCC-, Wang-Klassifikation), Therapie des Primärtumors, Therapie regionaler Lymphknoten und Immunhistochemie.

Ergebnisse Im vorliegenden Übersichtsartikel wurden 55 Veröffentlichungen ausgewertet. Die Ergebnisse hinsichtlich der untersuchten Aspekte sind in sich inhomogen.

Schlussfolgerungen Als Klassifikationssystem wird die Wang-Klassifikation empfohlen. Für die Behandlung kleinerer Tumoren (T1-T2-Wang) kommen operative Resektionen oder Bestrahlungen in Betracht. Größere Tumoren (T3-Wang) sollten reseziert und einer adjuvanten Bestrahlung zugeführt werden. Im Falle einer cT1-cT2cN0-Situation kann – eine dezidierte bildgebende Diagnostik vorausgesetzt – auf eine elektive Therapie der regionalen Lymphknoten verzichtet werden.

Abstract

Background Squamous cell carcinoma of the nasal vestibule is a rare entity. In consequence disagreement in etiology, staging system and therapy of primary tumor with or without adjuvant treatment of regional lymph nodes are apparent.

Methods Pubmed-Recherche of relevant literature concerning: lymphatic drainage, metastases, incidence, risk factors (leather, nickel, nicotine, human papillomavirus, Staging system (UICC, AJCC, Wang’s system), therapy of the primary tumor, regional lymph nodes and immunohistochemistry.

Results Fifty-five studies were found and analyzed. Results are inconsistent.

Conclusion The Wang-classification is recommended. Radiation and surgery are the treatment of choice for small lesions. Larger lesions (T3-Wang) should be treated with a combined approach. In cT1-cT2cN0-situation after accurate diagnostic, an elective therapy of regional lymph nodes is not necessary.

Fußnote

* Geteilte Letztautorenschaft


 
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