头颈部炎性肌纤维母细胞瘤临床分析

Clinical features of inflammatory myofibroblastic tumor in the head and neck

目的总结头颈部炎性肌纤维母细胞瘤的临床特点，探讨其治疗方法。方法回顾性分析2004-2012年27例头颈部炎性肌纤维母细胞瘤患者的临床资料，其中男12例，女15例；年龄8—77岁，中位年龄43岁。27例患者发病部位颈部5例，鼻腔及鼻窦6例，耳及颞部4例，喉部3例，腮腺2例，下咽2例，上颌骨1例，下颌骨1例，面部咬肌1例，扁桃体1例，鼻咽部1例。治疗方法包括：放射治疗1例，单纯手术治疗22例，手术并术后辅助放疗3例，术前同步放化疗并手术肿物切除1例。结果本组患者随访4～85个月，中位随访时间26个月；6例失访；1例发生恶性转化，16例预后良好，4例复发，其中2例带瘤生存，2例死亡。结论头颈部炎性肌纤维母细胞瘤是具有恶性倾向的间叶性肿瘤，具有一定的复发率和致死率。手术彻底切除仍为目前首选的治疗方法，放疗和化疗的作用有待进一步探讨。

Objective To summarize the clinical characteristics of inflammatory myofibroblastic tumor （IMT） in head and neck and to discuss its treatment. Methods Twenty-seven cases of IMT in head and neck diagnosed at the Chinese PLA General Hospital from 2004 to 2012 were analyzed retrospectively. Among the 27 patients, 12 males and 15 females, age ranged from 8 to 77 years, with a median 43 years old. Treatment included： 1 with radiotherapy, 22 with surgery, 3 with surgery and postoperative radiotherapy, one with concurrent chemoradiotherapy followed by surgery. Of the 27 cases, 5 located in the neck, 6 in the nasal and paranasal sinus, 4 in the temporal bone, 3 in the throat, 2 in the parotid gland, 2 in the lower pharynx, 1 in the mandible, 1 in the maxilla, 1 in the masseter muscle, 1 in the amygdala and 1 in the pharynx nasalis. Results Following-up time was 4 - 85 months, with a median of 26 months. Six cases lost follow-up, 1 case with malignant transformation and died, 16 cases survived with no recurrence, 4 cases relapsed, of whom 2 were alive with tumors and 2 died. Conclusions IMT in the head and neck has a tendency to be malignancy, with certain recurrence rate and mortality. Radical excision is still the first choice of treatment for IMT in head and neck.