头颈部多发性副交感节瘤的诊治(附1例报告并文献复习)

The diagnosis and treatment of multicentric paragangliomas in head and neck (A report of one case with literature review)

目的 提高临床医生对头颈部多发性副交感节瘤的认识。方法 回顾分析我科近期收治的 1例巨大颈静脉球体瘤并同侧迷走神经副交感节瘤 ,并文献复习头颈部多发性副交感节瘤的临床表现、诊断、手术方法。结果 本病例的临床表现与肿物发生部位、侵犯范围有关。影像学检查 ,特别是CT血管显影三维重建技术可清楚显示病灶范围、血供情况。本例采用改良颞颈“Y”型联合径路 ,完整切除肿物 ,无重大并发症 ,术后随访 9个月 ,无复发。结论 头颈部多发性副交感节瘤临床罕见 ,其临床表现与肿物发生部位、侵犯范围及分泌状况有关 ,额外病灶易被忽略漏诊。影像学检查对本病的诊断、手术、随访有重大意义。

Objective To enhance the recognition of multicentric paragangliomas in head and neck. Methods One case of giant glomus jugulare with ipsilateral glomus vagale was diagnosed and treated recently. The relevant literature was reviewed. Results The clinic manifestation of multicentric paragangliomas depended on the location and invasive degree of the tumor. Imageology, especially the computer tomographic artery volume reconstruction (CTAVR) technique, showed excellently the invasive extent and blood supply of the lesion. A modified “Y” type incision was adopted, and the tumor was resected completely without any conspicuous complications. The patient was followed up without recureence for 9 months after the operation. Conclusion The multicentric paragangliomas in head and neck is very rare tumor. Its clinic manifestations are associated with the tumor's location, invasive degree as well as secretive condition. The additional lesion of multicentric paragangliomas in head and neck is easily neglected. Imageology is very helpful in diagnosis, operation and postoperative follow-up. Exact selection of operation approach and master of operation technique are the key point to the successful operation and avoiding the fatal complications.