青春期鼻咽纤维血管瘤自行消失病例评述

Spontaneous regression of juvenile nasopharyngeal angiofibroma

青春期鼻咽纤维血管瘤(JNA)能否自行消失是一个长期争论的问题。本文报告1例经活检证实鼻咽纤维血管瘤自行消失的病例。患者男性,16岁,因严重鼻出血于1975年初诊为JNA。术后1年复诊,见复发。术后3年半,复诊发现:肿瘤自鼻咽顶后壁延及左后鼻孔,患者不再接受治疗。6年后(患者25岁时)随访复查,肿瘤完全消失,症状消失。笔者温习文献6篇共7例JNA自行消失病例,发现肿瘤自行完全消失的患者年龄为20~39岁,另有1例不详。JNA自行消失的机制目前尚不明确。本文对JNA自行消失的诊断依据及术后复发处理作了讨论。

There has been long-standing arguments over whether or not juvenile nasopharyngeal angiofibroma （JNA） could regress spontaneously. The author reported one case with spontaneous regression of a biopsy-proved JNA. A 16-year-old boy presented in 1975 with a history of severe epistaxis, and was initially diagnosed as JNA. Tumor recurrence was observed one year after the surgery. Three and a half years after the surgery, the tumor occupied the roof- posterior wall of nasopharynx and extended to the left choana. He did not receive any treatment after that time. Six years later when the patient was twenty-five years old, he denied any treatment, and the tumor disappeared completely. The author reviewed literatures discoursing 6 reports on the JNA in total 7 patients with spontaneous regression. The age of patients when the tumor completely regressed was between 20 and 39 years old, and it was unclear in one ease. The exact mechanism of regression remains unclear to date. The diagnosis of spontaneous regression of JNA and the treatment of recurring tumor after operation were discussed.