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

在鼻咽部以外,未分化癌仅在其他头颈部部位很少发生。尽管未分化鼻咽癌与爱泼斯坦-巴尔病毒 (EBV) 之间的关联是一致的,但关于EBV与鼻咽部以外未分化癌的关联的证据却相互矛盾。在这里,我们报告了一例未分化的舌根癌。一名71岁的男性,9年前曾接受过原发性未知的右颈转移性EBV阳性未分化癌的放射治疗,被转诊到我们的诊所,舌根和右颈有肿块。舌根病变被发现是EBV阳性未分化癌。他接受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重建了舌根缺损。由于舌根的手术切缘阳性,术后增加了再照射。治疗后20个月,患者目前还活着,没有复发或远处转移。尽管目前尚不清楚我们的病例是复发还是新开发的EBV潜伏感染的未分化癌,但我们建议在治疗至少10年以上后应仔细观察EBV相关肿瘤。

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