Outside the nasopharynx, undifferentiated carcinomas occur only rarely at other head and neck locations. Although the association between undifferentiated nasopharyngeal carcinoma and Epstein-Barr virus (EBV) is consistent, there is conflicting evidence as to the association of EBV with undifferentiated carcinomas outside the nasopharynx. Here, we report on a case of undifferentiated carcinoma of the tongue base. A 71-year-old male, who had been treated with irradiation for primary unknown right neck metastatic EBV-positive undifferentiated carcinoma 9 years previously, was referred to our clinic with masses at the tongue base and right neck. The lesion at the tongue base was revealed to be an EBV-positive undifferentiated carcinoma. He was treated with resection of tongue base tumor and bilateral-neck dissection, and the defect at the tongue base was reconstructed with a free rectus abdominis myocutaneous flap. Re-irradiation was added post-operatively because of a positive surgical margin at the tongue base. The patient is presently alive without recurrence or distant metastasis 20 months after treatment. Although it is unclear whether our case is recurrent or newly developed EBV-latently infected undifferentiated carcinoma, we propose that EBV-associated tumors should be carefully observed after treatment at least for more than 10 years.

译文

:在鼻咽以外,未分化癌仅在其他头颈部位置很少发生。尽管未分化的鼻咽癌和爱泼斯坦-巴尔病毒(EBV)之间的关联是一致的,但关于EBV与鼻咽外未分化癌的关联有相互矛盾的证据。在这里,我们报道一例未分化舌基癌。一位71岁的男性在9年前接受过放射治疗,原发性右颈部转移性EBV阳性原发性未分化癌已经接受了放射治疗,现被转诊至我们的诊所,舌头和右颈部有肿块。舌根处的病变显示为EBV阳性未分化癌。对他进行了舌根肿瘤切除术和双侧颈淋巴结清扫术,并用游离的腹直肌肌皮瓣修复了舌根缺损。由于舌根的手术切缘阳性,因此在术后增加了再次照射。治疗后20个月,该患者目前尚无复发或远处转移。尽管尚不清楚我们的病例是复发的还是新发的EBV潜伏感染的未分化癌,但我们建议治疗至少10年后应仔细观察与EBV相关的肿瘤。

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