神经节细胞瘤20例

Clinical Analysis of 20 Children with Ganglioneuroma

目的提高对小儿神经节细胞瘤的术前诊断率,改良手术方式,为改善预后提供依据。方法回顾性分析20例神经节细胞瘤患儿的临床资料。男9例,女11例;对其临床、病理特点、生物学特性及治疗原则进行分析。结果无临床症状患儿15例;B超检查16例,均可发现实质性低回声包块;CT平扫20例,为低密度到中等密度病灶,增强后显著强化;MRI检查14例,T1W1呈低信号,T2W1为不均匀高信号。患儿均行手术切除肿瘤,14例完整切除,4例部分切除,2例仅取活检。随访15例,复发1例。结论小儿神经节细胞瘤多为发生于胸腹交感链,生长缓慢的良性肿块。结合本文所总结的B超、CT、MRI影像学特点,术前可获提示性诊断。手术切除肿瘤时应注意切口的选择并避免损伤周围重要血管,病检证实含神经母细胞瘤成分患儿建议采用预防性化疗,远期随访效果良好。

Objective To increase the preoperative diagnosis rate, reform the operation and improve the prognosis in children with ganglionauroma. Methods Clinical data of 20 children with ganglioneuroma hospitalized in Tongji hospital of Huazhong university of science and technology from Nov. 1986 to May. 2006 Were reviewed （ male 9, female 11 ）. The biological, clinical and pathological characteristics of patients were analyzed. Results Among these 20 patients, 15 cases were discovered to have no clinical symtom. The B ultrasound showed low - echo in all 16 cases. Under CT scan,20 cases showed low to moderate density shadows,and the distinct enhancement in these tumors was noted with enhanced CT scan. Fourteen cases undergoing MR1 all showed low signals in T1W1 and inhomogeneous high signals in T2W1. All patients underwent surgical operations,completely removed in 14 cases,partly in 4 cases, and biopsy was performed only in 2 cases. Fifteen cases were followed up from 7 months to 6 years,tumor recurrence happened only in 1 case. Conclusions Ganglioneuroma is mostly found in chest - abdominal sympathetic chain,it grows up slowly and seems to be innocent. The imaging data of B ultrasound, CT and MR1 can give helpful information in the diagnosis of ganglioneuroma. We shall pay attention to the choice of incision and avoidance of injuring the important blood vessels during the operation. Children who have neuroblastoma cells should receive prophylactic chemoprophylaxis treatment and the result of long - time follow up is satisfactory.