鼻腔鼻窦炎性肌纤维母细胞瘤临床分析

Clinical analysis of imflammatory myofibroblastic tumor of the nasal cavity and paranasal sinus

目的：探讨鼻腔鼻窦炎性肌纤维母细胞瘤（IMT）的临床特点、治疗方法及疗效。方法：回顾性分析经病理确诊的鼻腔鼻窦炎性肌纤维母细胞瘤14例患者的临床资料,其中手术治疗12例,手术并术后辅助放疗2例。结果：随访1~7年,术后2例经病理检查证实为低度恶性IMT。至末次随访,8例预后良好,6例复发,其中4例死亡,2例带瘤生存。结论：IMT很少见,诊断主要依靠病理及免疫组织化学检测。正确的诊断很有必要,以避免破坏性或毁容手术。手术彻底切除仍为目前首选的治疗方法,放化疗的作用有待进一步探讨。该病术后复发率较高,需长期随访。

Objective：To investigate the clinical features, therapeutic methods and therapeutic efficacy of im- flammatory myofibroblastic tumor（IMT）of the nasal cavity and paranasal sinuses. Method：Clinical data of 14 cases diagnosed as IMT by pathology were retrospectively analyzed. There were 8 males and 6 females,age ranging from 18 to 77 years. 12 cases of them were treated by surgery while 2 cases received postoperative radiotherapy. Result： All cases were operated. All the patients were followed up for a period of 1 to 7 years after operation and two cases were proved low grade IMT pathologically. Eight cases survived with no recurrence until the last follow-up and 6 cases relapsed, of which 4 cases died and 2 were alive with tumor. Conclusion：IMT of the nasal cavity and paranasal sinuses is very rare. The diagonosis of IMT is based on pathology and immunohistochemistry. Proper diagnosis is essential to avoid mutilating and disfiguring surgical procedures. Radical excision is still the first choice of treat- ment for IMT of the nasal cavity and paranasal sinuses. Chemotherapy and radiotherapy may not be helpful to prevent recurrence after operalion. Due to high recurrence rate, long term follow up is necessary after operation.