鼻腔鼻窦血管外皮细胞瘤临床分析

Clinical analysis of sinonasal hemangiopericytoma

目的 探讨鼻腔鼻窦血管外皮细胞瘤患者的临床特点、治疗方法及预后.方法 回顾性分析四川省人民医院1990年1月至2012年12月经病理确诊的6例鼻腔鼻窦血管外皮细胞瘤患者的临床资料,其中男4例,女2例,年龄35～ 65岁,中位数年龄58岁.临床表现为鼻塞和鼻出血.全部患者均行鼻内镜下或鼻内镜辅助下肿瘤切除术,其中2例肿瘤位于鼻腔的患者,行鼻内镜下鼻腔肿瘤切除术.4例肿瘤位于鼻腔及鼻窦的患者,在全麻下行鼻内镜辅助下鼻腔鼻窦肿瘤切除术.结果 全部患者随访6个月至7年,4例未见复发;1例术后6个月复发,行二次手术,二次手术后随访1年未见复发;1例术后17个月复发,行二次手术,二次手术后9个月再次复发,现带瘤生存至今超过2年.结论 鼻腔鼻窦血管外皮细胞瘤少见,鼻内镜下或鼻内镜辅助下手术切除鼻腔鼻窦血管外皮细胞瘤可取得满意的疗效.

Objective To investigate the clinical features,therapeutic methods and therapeutic effects of sinonasal hemangiopericytoma.Methods Clinical data of 6 patients with sinonasal hemangiopericytoma,diagnosed by pathology and immmunohistochemistry between January 1990 and December 2012 were analyzed retrospectively.There were 4 males and 2 females,with a median age of 58 years.Clinical manifestation included epistaxis and nasal obstruction.These patients were operated on by nasal endoscopic surgery or endoscope-assisted surgery,of which 2 cases of tumor located in the nasal cavity underwent nasal endoscopic surgery and 4 cases of tumor located in the nasal cavity and sinuses underwent endoscope-assisted surgery.Results All the patients were followed up for a period of 6 months to 7 years after operation.Two cases recurred and 4 cases didn＇t recurre.One case recurred 6 months after operation and underwent second operation,with no recurrence by further one year follow-up.Another case recurred 17 months after operation and underwent second operation,with recurrence by further 9 months follow-up.This patient lived with tumor over two years.Conclusions Hemangiopericytomas are rarely found in the sinonasal cavity.Nasal endoscopic or endoscope-assisted surgery provides satisfactory effect.