儿童软组织肉瘤15例误诊分析

Misdiagnosis Analysis of 15 Cases of Soft Tissue Sarcoma in Children

目的分析儿童软组织肉瘤的临床特征及误诊原因,总结防范误诊措施。方法回顾性分析2012年6月—2018年10月收治的误诊为其他疾病的儿童软组织肉瘤15例的临床资料。结果15例均因患儿家长发现患儿体表肿块就诊,均为单发病灶,发病部位为躯干9例,四肢3例,头颈2例,阴唇1例,肿块直径为0.4~5(1.82±0.24)cm。误诊时间15~20 d,误诊为表皮样囊肿7例,皮脂腺囊肿、纤维瘤各3例,脂肪瘤2例,均行单纯性肿块切除。经术后病理检查确诊为软组织肉瘤,确诊为纤维肉瘤9例,横纹肌肉瘤、脂肪肉瘤各3例,确诊后行再次扩大切除术+化疗6例,行再次扩大切除术5例,行单纯化疗4例。15例3年生存率为60.00%(9/15),5年生存率为33.33%(5/15)。结论临床医师应加强对儿童软组织肉瘤的认识,综合分析相关资料,避免误诊误治。

Objective To analyze the clinical characteristics and causes of misdiagnosis of soft tissue sarcoma in children and to summarize the preventive measures.Methods The clinical data of 15 children with soft tissue sarcoma misdiagnosed as other diseases from June 2012 to October 2018 were analyzed retrospectively.Results All the 15 cases presented to our hospital because the parents found the lump on the body surface of the child.All of them had single lesion,and the tumor was located in the trunk(9 cases),limbs(3 cases),head and neck(2 cases),and labia(1 case).The diameter of the tumor was 0.4-5(1.82±0.24)cm.The duration of misdiagnosis was 15-20 d.It was misdiagnosed as epidermoid cyst in 7 cases,sebaceous cyst in 3 cases,fibroma in 3 cases,and lipoma in 2 cases.Simple mass resection was performed in all cases.After operation,pathological examination confirmed soft tissue sarcoma,including fibrosarcoma in 9 cases,rhabdomyosarcoma in 3 cases,and liposarcoma in 3 cases.After diagnosis,extended resection plus chemotherapy was given in 6 cases,extended resection in 5 cases and chemotherapy in 4 cases.The 3-year survival rate of 15 cases was 60.00%(9/15),and the 5-year survival rate was 33.33%(5/15).Conclusion Clinicians should strengthen the understanding of children's soft tissue sarcoma,and make comprehensive analysis of relevant data,to avoid misdiagnosis and mistreatment.