转移至喉部的肿瘤：系统综述。
完整摘要 · 中文译文
引言：来自非头颈部原发肿瘤的喉部转移性受累极为罕见，常被误诊为原发性喉部病变，并面临不当的侵袭性外科治疗风险。本系统评价旨在明确来自远处部位的喉转移性肿瘤最常见的原发来源、临床特征、诊断检查、治疗及生存结局。 方法：对PubMed、Web of Science和Scopus进行全面检索，识别1984年至2026年间发表的英文原始报告，由两名评价者根据系统评价和荟萃分析首选报告项目（PRISMA）建议独立筛选。 结果：共纳入83篇文章，包含113例经组织学确诊的喉部转移瘤患者；证据仅由单个病例报告和小型回顾性系列研究组成。患者主要为老年男性，平均年龄63.6岁。最常见的原发部位是前列腺（26.5%），其次是肾脏（18.6%）、结直肠（14.2%）、皮肤黑色素瘤（13.3%）、肺（8.8%）和乳腺（6.2%）。声门上区是最常受累的亚部位，软骨框架在近四分之一的病例中受累。原发诊断与喉转移之间的中位间隔为36个月，尽管约五分之一的患者喉部病变先于原发肿瘤出现或与之同时出现。声音嘶哑、呼吸困难或喘鸣以及吞咽困难是主要症状，临床上与原发性喉部肿瘤无法区分。治疗方式多样，且多为保守性或姑息性，总生存期通常以月计算。 结论：当已知或疑似喉外恶性肿瘤的患者出现喉部肿块时，应怀疑喉转移瘤，这提示在活检前进行全身分期，并采取多学科、个体化的管理策略。
完整摘要 · 英文原文
INTRODUCTION: Metastatic involvement of the larynx from nonhead and neck primary tumors is an exceptionally rare event, frequently misdiagnosed as a primary laryngeal lesion and at risk of inappropriately aggressive surgical management. This systematic review aimed to define the most common primary sources, clinical features, diagnostic workup, treatment, and survival outcomes of tumors metastatic to the larynx from distant sites. METHODS: A comprehensive search of PubMed, Web of Science, and Scopus identified original English-language reports published between 1984 and 2026, screened independently by two reviewers according to Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) recommendations. RESULTS: A total of 83 articles were included, comprising 113 patients with histologically confirmed laryngeal metastases; the evidence consisted exclusively of single case reports and small retrospective series. Patients were predominantly older men with a mean age of 63.6 years. The most frequent primary site was the prostate (26.5%), followed by kidney (18.6%), colorectum (14.2%), skin melanoma (13.3%), lung (8.8%), and breast (6.2%). The supraglottis was the most commonly involved subsite, and the cartilaginous framework was affected in nearly one-quarter of cases. The median interval between primary diagnosis and laryngeal metastasis was 36 months, although the laryngeal lesion preceded or coincided with the primary in roughly one-fifth of patients. Hoarseness, dyspnea or stridor, and dysphagia were the dominant symptoms, clinically indistinguishable from primary laryngeal tumors. Treatment was heterogeneous and largely conservative or palliative, and overall survival was generally measured in months. CONCLUSIONS: Laryngeal metastasis should be suspected whenever a laryngeal mass arises in a patient with a known or suspected extralaryngeal malignancy, prompting whole-body staging before biopsy and a multidisciplinary, individualized management strategy.