7例颞骨骨巨细胞瘤的临床分析

Giant cell tumor of temporal bone:a report of 7 cases

目的 :探讨颞骨骨巨细胞瘤 (giantcelltumoroftemporalbone ,GCTTB)的病因、诊断、鉴别诊断及合理的治疗方法。方法 :治疗方法以手术为主 ,7例中肿瘤根治性切除 5例 ,临界切除 2例 (术后 1年复发 ,病理Ⅱ级 )。结合经病理学证实的GCTTB的临床资料 ,复习有关文献并对 7例GCTB的临床、组织学和影像学等资料进行分析。结果 :7例GCTTB中 ,右侧颞骨 5例 ,左侧 2例。病理Ⅰ级 1例 ,Ⅰ～Ⅱ级 2例 ,Ⅱ级 4例。临床表现依肿瘤所在具体部位而有所不同 :耳鸣 6例 ,耳鸣伴听力损失 5例 ,其中有 2例患侧耳全聋。眩晕 2例 ,面瘫伴听力受损 1例。 3例术后行放射治疗 ,其中 2例疗效良好 ,1例复发 (为临界切除患者 )。结论 :明确诊断GCTTB必须综合临床、影像和病理三方面资料 ,手术彻底切除是最有效的治疗方法 。

Objective:To investigate the clinical course,auxiliary examinations,histologic feature,diagnosis,differential diagnosis and treatment of giant cell tumor of temporal bone (GCTTB).Method:Seven cases of GCTTB ,which arose in temporal bone, were collected from 1990 to 2002 and analyzed clinicopathologically.Result: Seven cases with the GCTTB are reported, including 3 females,4males. The age of 7patients between 9 to 53 years.Five tumors located in right side temporal bone,two in left side temporal bone.One patients was pathological Ⅰgrade ,twoⅠ～Ⅱgrade, and four Ⅱgrade.The clinical course were different according to the position of the tumors: including tinnitus 6 cases ,tinnitus with hear loss 5cases(2 cases with anakus of trouble side ear),vertigo 1 case,facial paralysis with hear loss 1 case.Radical resections were performed in five cases and subtotal resections in two(recurrence,one year after operation,Ⅱgrade pathologically). Postoperative Radiotherapy was conducted in three cases .Conclusion:Diagnosis of GCTTB is based on typical histologic features and imagine as well as clinical information. Complete surgical resection is believed to be the most suitable treatment for GCTTB and postoperative radiotherapy may be effective.