PDF(Pubmed)
Abstract：
This case report describes a distinctive presentation of invasive metastatic tonsillar head and neck squamous cell carcinoma (HNSCC) that recurred in a 34-year-old African American inmate, defying the expectations of conventional risk factors. This case underscores the significance of nuanced care in atypical HNSCC scenarios. The patient presented in October 2021 with bilateral lymphadenopathy and dysphagia, which led to the diagnosis of tonsillar squamous cell carcinoma. The patient\'s treatment trajectory included radiation therapy with concurrent cisplatin, a subsequent radical right neck dissection, and immunotherapy. Complications, including abscess formation, neutropenic fever, and anemia, necessitated a multidisciplinary approach and admission to Reception and Medical Center Hospital. Cultures revealed a distinct neck mass that cultured positively for a variety of bacteria. The patient\'s condition was significantly improved by strategic interventions and meticulous daily wound care. This case prompts exploration into unknown factors contributing to HNSCC development in a seemingly low-risk individual, challenging conventional risk profiles. Treatment challenges, including radiation, surgery, and immunotherapy, underscore the need for a multifaceted approach. The central role of intense wound care in mitigating complications and improving the patient\'s quality of life is pivotal. The patient\'s tumor and infection highlight the urgency of improving prison sanitation. Enhanced hygiene and health screenings could have lessened the severity of the patient\'s condition, underscoring the need for comprehensive health measures in correctional facilities. Moreover, specialized wound care has the potential to improve outcomes and reduce health risks within incarcerated populations.
摘要：
该病例报告描述了在34岁的非裔美国囚犯中复发的浸润性转移性扁桃体头颈部鳞状细胞癌（HNSCC）的独特表现。无视传统风险因素的预期。此案强调了在非典型HNSCC场景中细微差别护理的重要性。该患者于2021年10月出现双侧淋巴结肿大和吞咽困难，这导致了扁桃体鳞状细胞癌的诊断。患者的治疗轨迹包括同步顺铂放疗，随后的右颈彻底解剖,和免疫疗法。并发症,包括脓肿形成,中性粒细胞减少症,贫血,需要采用多学科方法，并进入接待和医疗中心医院。培养物显示出明显的颈部肿块，对各种细菌均呈阳性培养。通过战略干预和细致的日常伤口护理，患者的病情得到了显著改善。这个案例提示探索导致HNSCC发展的未知因素，在一个看似低风险的个体中，挑战传统的风险概况。治疗挑战，包括辐射,手术,和免疫疗法，强调需要采取多方面的方法。强化伤口护理在减轻并发症和改善患者生活质量方面的核心作用至关重要。患者的肿瘤和感染凸显了改善监狱卫生的紧迫性。加强卫生和健康检查可以减轻患者病情的严重程度，强调惩教设施需要采取全面的卫生措施。此外，专门的伤口护理有可能改善结果并降低被监禁人群的健康风险.
