鼻腔鼻窦孤立性纤维性肿瘤1例报道及文献复习

Solitary fibrous tumor of the nasal cavity and sinuses:a case report and literature review

目的探讨发生于鼻腔鼻窦的孤立性纤维性肿瘤(SFT)的临床诊治经验。方法结合1例鼻腔及鼻窦SFT患者的病例资料,并回顾性分析国内外文献,对SFT的临床特点、诊断与治疗进行讨论。本例患者术前CT提示:左侧鼻腔鼻窦肿物性质不明,鼻腔息肉可能。予以鼻腔新生物活检后鼻腔出血量大,随即全麻下行鼻内镜左侧鼻腔鼻窦新生物切除术,并给予止血、填塞等对症处理。结果术后病理证实为鼻腔、鼻窦肿物符合SFT。患者恢复良好,术后半年复查未见复发。结论 SFT是一类好发于胸膜的间叶性肿瘤,但发生于鼻腔鼻窦的非常少见。影像学对于鼻腔鼻窦新生物的诊断只有辅助性意义,临床医生需要结合患者病史、临床表现、病理检查结果正确诊断与治疗。

Objective To explore the clinical experience in the diagnosis and treatment of solitary fibrous tumor(SFT) of the nasal cavity and sinuses.Methods The clinical characteristics, diagnosis and treatment of SFT were discussed by retrospectively analyzing the data of the patient with SFT in the nasal cavity and sinuses in combination with domestic and foreign literatures. Preoperative CT of this patient indicated that the mass nature of the left nasal cavity and paranasal sinus mass was uncertain, and nasal polyps were possible. There was a large amount of bleeding in the nasal cavity after the nasal biopsy. Immediately, the neoplasm of left nasal and paranasal sinuses was removed by endoscopy under general anesthesia. At the same time, hemostasis and tamponade were treated.Results Postoperative pathology confirmed SFT of nasal cavity and sinus. Postoperatively, the patient recovered well, and no recurrence was observed in the reexamination half a year after the operation.Conclusions SFT is a type of mesenchymal neoplasm that usually occurs in the pleura, but rarely occurs in the nasal cavity and sinuses.Imaging has only auxiliary significance for the diagnosis of neoplasms in the nasal cavity. Clinicians should make a correct diagnosis and treatment plan based on the patient’s medical history, clinical manifestations and pathological examination results.