口底畸胎样囊肿10例临床病理分析

Retrospective analysis of 10 congenital teratoid cysts of the mouth floor

目的:探讨口底畸胎样囊肿临床病理及手术治疗的时机选择。方法:对2000年4月—2008年5月有详细记载的10例口底畸胎样囊肿的临床特点、组织学表现、治疗方法及预后进行回顾性分析和讨论。结果:口底畸胎样囊肿多发生于新生儿及儿童,表现为活动的囊性肿块,与周围组织界限清楚。由于位于口底,常导致患儿出现不同程度的呼吸困难、进食困难,从而影响患儿的生长发育。组织学观察该囊肿除复层鳞状上皮衬里外,还有呼吸道上皮和(或)胃肠上皮。所有患儿均采用手术摘除,随访3～103个月无复发。在对患儿呼吸道无明显压迫等情况下,可以待患儿身体状况较好时行囊肿摘除术。结论:口底畸胎样囊肿由于生长位置的特殊性,尽管系囊性病变,但对患儿影响较大。B超、CT、MRI检查有助于早期诊断及处理,早期手术彻底切除预后良好。

PURPOSE： To analyze the clinicopathology of the teratoid cyst of the floor of the mouth and the time for surgical treatment. METHODS： The incidence, manifestations, histology, treatment methods and prognosis of 10 patients treated in our department between April 2000 and May 2008 were reviewed. RESULTS： The lesions occurred almost exclusively in neonates and children. It appeared as mobile, cystic solid and well-defined lesions. It frequently caused difficulty in feeding, breathing and even more affecting growth and development because of its special location. Histology indicated that squamous, respiratory and /or gastrointestinal epithelium constituted basic structure of teratoid cyst. Complete surgical extirpation was the only treatment of choice. It was not routinely necessary to do the operation immediately unless the cyst oppressed the airway of the patients. There had been no recurrence of the lesion during follow-up. CONCLUSION： Teratoid cysts have great impact on the patients due to its specific location, ahhough it is a cystic disease. B-type ultrasonography, CT and MRI are helpful to the diagnosis. Early complete excision is mandatory with good prognosis.