后纵隔哑铃型神经源性肿瘤的诊断和外科治疗

Diagnosis and surgical treatment for mediastinal neurogenic dumbbell tumor

目的探讨后纵隔哑铃型神经源性肿瘤的临床病理特征、诊断、鉴别诊断及外科治疗方法,提高临床诊治水平。方法回顾性分析16例后纵隔哑铃型神经源性肿瘤的相关临床资料,并结合文献进行复习。结果16例中男9例,女7例,12例有胸闷、胸痛、咳嗽和肢体麻木等临床症状,1例双下肢瘫痪,3例无症状。全部病例经胸部CT和磁共振检查提示诊断,均行一期完整切除肿瘤,治愈出院。结论手术方案应根据肿瘤大小、部位和生长形态等因素选择手术方案。采用后正中切口联合胸腔镜辅助手术是治疗后纵隔哑铃型神经源性肿瘤较佳手术方式。

Objective To explore the clinical and pathologic characteristics, diagnosis, differential diagnosis, and surgical treatment of mediastinal neurogenic dumbbell tumor,thereby to improve level of its clinical diagnosis and treatment. Methods The data of 16 patients with mediastinal neuregenic dumbbell tumor were retrospectively analyzed, and the literature was reviewed. Results In 16 patients,9 cases were male and 7 cases were female; 12 cases were presented as chest distress, chest pain, cough, and numb of limbs. 1 patient was manifested with bi - lower limbs paralysis. 3 patients who did not suffer from the manifestation displayed incidently by physical examination. All patients underwent chest CT scan and magnetic resonance. Completed resection at the stage one was achieved in all the patients. Conclusion The selecting of surgical procedure should be based on size of tumor and location, and was carried out by individual design. A collaborated approach with thoracoscope and pestermedial incision is recommended.