摘要
目的探讨额窦恶性肿瘤的临床表现、鉴别诊断及治疗方法。方法回顾性分析我科2009~2017年收治的5例额窦恶性肿瘤患者的临床资料,并复习相关文献。结果3例全麻下行鼻外额窦切开、鼻内镜下经鼻联合路径病变切除,1例行鼻内镜下DrafⅢ型额窦手术(辅助眉弓切口),1例局麻下行额部切开活检术。病理类型:转移性乳腺癌1例,弥漫大B细胞性淋巴瘤2例,鳞状细胞癌1例,乳头状瘤癌变1例。术后辅助放疗2例,化疗1例,放疗+化疗1例。术后随访3年,死亡3例,1例带瘤生存,1例完全缓解。结论额窦原发性恶性肿瘤少见,偶有由身体其他部位而来的转移性癌,初起常无症状,早期诊断困难,首发症状常为额部肿块、眼球突出,影像学检查有助于鉴别良恶性,确诊依靠病理检查。本病预后较差,治疗应根据病理类型行鼻内外联合径路彻底切除病变或(和)放化疗。
Objective To explore the clinical manifestations,differential diagnosis and treatment of frontal sinus malignant tumors.Methods The clinical data of 5 patients with frontal sinus malignancy from 2009 to 2017 were analyzed retrospectively,and the relevant literature was reviewed.Results Three patients underwent extranasal frontal sinusotomy and transnasal endoscopic resection of lesions under general anesthesia.One patient underwent draftⅢfrontal sinus surgery(assisted by eyebrow arch incision)with nasal endoscope,and one patient underwent frontal tumor biopsy under local anesthesia.Pathological types:1 case of metastatic breast cancer,2 cases of diffuse large B-cell lymphoma,1 case of squamous carcinoma1,1 case of papilloma canceration.Postoperative adjuvant radiotherapy was performed in 2 cases,chemotherapy in 1 case,and radiotherapy combined with chemotherapy in 1 case.Follow-up observations for 3 years showed that 3 cases died,1 case survived with tumor,and 1 case achieved complete response.Conclusions The primary malignant tumors of frontal sinus are rare,and occasionally the tumor maybe metastatic.It is often asymptomatic and difficult to diagnose at the early stage.The first symptoms are often forehead lumps and exophthalmos.Imaging examination is helpful to distinguish benign from malignant ones,and the diagnosis depends on pathological examination.The prognosis is poor,and the treatment including surgical operation,radiotherapy and chemotherapy should be carried out based on the pathological type.
作者
张国民
胡翠玉
高松
马贺
王志杰
吴文斌
ZHANG Guomin;HU Cuiyu;GAO Song;MA He;WANG Zhijie;WU Wenbin(Department of Otolaryngology,The 909th Hospital of Joint Logistic Support Force,South-East Hospital Affiliated to Xiamen University,Zhangzhou,363000,China;不详)
出处
《中国中西医结合耳鼻咽喉科杂志》
2021年第5期356-359,共4页
Chinese Journal of Otorhinolaryngology in Integrative Medicine
基金
联勤保障部队第九○九医院青年苗圃基金(18Y029)。
关键词
鼻窦肿瘤
额窦
诊断
治疗
paranasal sinus neoplasm
frontal sinus
diagnosis
treatment
作者简介
通信作者:吴文斌,主治医师.Email:187390849@qq.com。
