鼻腔鼻窦畸胎癌肉瘤1例诊治分析

Analysis of diagnosis and treatment of sinonasal teratocarcinosarcoma

目的提高临床医师对鼻腔鼻窦畸胎癌肉瘤(SNTCS)的认识,提高SNTCS早期诊断效率及疗效,改善患者预后。方法回顾2019年1月收治的鼻腔畸胎癌肉瘤患者1例,影像学明确鼻腔占位性病变后行病灶切除;以“CNKI、Pubmed”为检索工具复习相关文献并探讨其临床特征、影像学表现、鉴别诊断、治疗及预后。结果本例患者术后病理提示为左侧SNTCS,术后根据病理结果给予放、化疗,随访1年未见明显复发征象。检索结果提示:“CNKI、Pubmed”检索平台搜索相关文献共89篇,排除标准后最终入选文献55篇,其中含SNTCS患者95例,但缺乏大宗样本报道,本研究是迄今为止最大样本的研究。结论SNTCS非常罕见,具有侵袭性高、生长迅速的特点,确诊需依赖病理学诊断,早期诊断并及时手术治疗辅以放化疗综合方案可适当延长患者寿命,此类型肿瘤预后差,应尽早诊治。

Objective In order to deepen the understanding of clinicians on Sinonasal teratocarcinosarcoma(SNTCS),improve the early diagnosis of SNTCS,the curative effect and prognosis of the patients.Methods A case of SNTCS in January 2019 was reviewed.The lesion was resected after a mass lesion occupying the nasal cavity was confirmed by imaging.CNKI and PubMed were used as search tools to review the relevant literature and discuss the clinical characteristics,imaging manifestations,differential diagnosis,treatment and prognosis of SNTCS.Results The postoperative histopathological examination of this case revealed SNTCS in the left nasal cavity.No recurrence was found in the 1 year follow-up period.A total of 89 relevant literatures were searched on the retrieval platform of"CNKI and Pubmed".55 literatures of them with 95 cases were finally selected after the exclusion of the criteria.However,there was no bulk sample report.This study is the largest one so far.Conclusions SNTCS is very rare,which has the characteristics of high invasion and rapid growth.The diagnosis of SNTCS depends on pathological diagnosis.Early diagnosis and timely surgical treatment combined with radiotherapy and chemotherapy can appropriately prolong the life of the patients with SNTCS.The prognosis of SNTCS is poor,so it should be treated as soon as possible.