头颈部孤立性纤维瘤的临床病理及预后分析:附6例报告

Clinical pathology and prognosis of solitary fibrous tumors in the head and the neck: a report of 6 cases

目的探讨孤立性纤维瘤的临床特征、诊断、鉴别诊断、治疗原则及预后情况,以提高对该疾病的诊治水平。方法回顾性分析头颈部孤立性纤维瘤6例的临床特征、影像学表现、手术方法、术后HE染色及免疫组织化学特征以及预后情况。结果患者伤口均为一期愈合,未见明显并发症。术后1例失访,余者随访12～28个月,未见肿瘤复发。术后HE染色证实均为孤立性纤维瘤,并且肿瘤细胞免疫组化显示CD34及Vim均为阳性。结论头颈部孤立性纤维瘤是一种少见的、大多数病例临床上呈良性经过、偶有恶变倾向的中间型及恶性肿瘤,确诊需依赖完整标本的免疫组化检查。首选的治疗方法是根治性切除肿瘤,患者一般预后良好。

Objective To discuss the clinical features, diagnosis, differential diagnosis, treatment principles and prognosis of solitary fibrous tumor（SFT） in the head and the neck. Method 6 cases of head and neck SFr were retrospec- tively analyzed in clinical features, imaging findings, surgical techniques and postoperative HE staining immuno-histo- chemical characteristics of chemistry and prognosis. Results All were primary healing without significant complica- tions. In a follow-up of 12-28 months, recurrence was not found in 5 patients. 1 patient lost follow-up. Post-operative pa- thology diagnosis was SPT and of all tumor cells were immune-histochemically positive for CD34 and Vim. Conclusion SFFs in the head and the neck are rare, and most are clinically benign, occasional with recurrence and metastasis of intermediate tumor. Diagnosis must depends on immune-histochemistry of the whole specimen. Complete radical resection is the first choice of treatment. Long-term close follow-up is mandatory because of aggression in the small number of case.