上颌窦低级别肌纤维母细胞肉瘤的临床诊治

Diagnosis and treatment of low-grade myofibroblastic sarcoma in maxillary sinus

目的探讨上颌窦低级别肌纤维母细胞肉瘤的临床特点、诊断和治疗。方法回顾性分析4例上颌窦低级别肌纤维母细胞肉瘤患者的临床资料和病理特征。结果 4例患者均采用上颌骨切除术,其中1例为上颌骨扩大切除,1例患者行术前放疗且剂量大于60 Gy。术后随访6个月至3年,未见复发,未出现其他并发症。结论上颌窦低级别肌纤维母细胞肉瘤为低度恶性肉瘤,术中冰冻切片诊断困难,确诊需术后病理及免疫组化结果。根据病灶范围行上颌骨切除或扩大切除达到根治肿瘤的目的。

Objective To explore the clinical characteristics, diagnosis and treatment of low-grade myofibroblastic sarcoma in maxillary sinus （LGMS）. Methods Clinical data and pathologic characteristics of 4 patients with LGMS was reviewed retrospectively. Results The initial symptom of this tumor was cheeks pain. All the four patients received maxillectomy. Of them, extended maxillectomy was applied to one case, and preoperative radiotherapy with a total dosage of 60 Gy to another one. The tumor was totally removed in all 4 cases. No complications occurred. The patients were followed up for 6 months to 3 years without recurrence. Conclusions LGMS is confirmed as a low-grade malignant tumor. It is difficult to make early diagnosis through frozen section. Final diagnosis of this tumor depends on paraffin section and immunohistochemistry. Maxillectomy or extended maxillectomy is the classic approach for tumor removal.