喉炎性肌纤维母细胞瘤的系统分析并附一例报道

Systematic review of laryngeal inflammatory myfibroblastic tumor with one case report

目的对喉炎性肌纤维母细胞瘤(laryngeal inflammatory myfibroblastic tumor,LIMT)进行系统评估并报道了一新发案例。方法对一例LIMT的发病、诊治过程进行回顾性分析,并采用多个数据库进行文献检索,对搜索到的文章进行系统性复习。结果本文报道一例男性新发病例。经查阅文献,共统计出68例LIMT,病人的平均年龄是43.9岁(2.5~86岁),男性多于女性(50/18),主要症状为声音嘶哑。最常见的部位是声门区(46/68,67.6%),平均病灶大小直径为1.6cm(0.2~3.5cm,n=36),主要的治疗方法有喉镜下切除,包括激光切除(n=55,80.8%),但一些患者需要喉裂开术(n=8,11.7%),部分喉切除术(n=4,5.8%),甚至全喉切除术(n=1,1.4%)。局部复发比例较高(n=18,26.5%),但远处转移率低(n=1,1.4%),复发病例采取再次手术,预后较好。结论LIMT是一种罕见的具有中间生物学特性的良性肿瘤,有局部浸润和复发的潜能,要避免不必要的多次活检,治疗上以根治性手术切除为主,预后良好,术后应密切随访以尽早发现复发。

Objective A systematic evaluation of laryngeal inflammatory myfibroblastic tumor(LIMT)was conducted and a new case was reported.Methods A retrospective analysis of the pathogenesis,diagnosis and treatment of a new case of LIMT was performed.A number of literatures were retrievaluaed from domestic and foreign databases,and were systematically reviewed.Results A new male case was reported in this paper.We reported totally 68 cases of LIMT.The mean age at the time of presentation was 43.9 years(range,2.5~86 years),and the males were more than females(50/18).The most common symptom was hoarseness.The most common location was the glottic region(46/68;67.6%)and the average lesions size was 1.6cm(range,0.2~3.5cm,n=36).The main treatment was microlaryngoscopy excision,including laser resection(n=55;80.8%),larynx split cordectomy(n=8,11.7%),partial laryngectomy(n=4,5.8%),and even total laryngectomy(n=1;1.4%).There was a high local recurrence rate(n=18,26.5%)but a low rate of distant metastasis(n=1;1.4%).The recurrent cases had a good prognosis after they underwent additional operations.Conclusions LIMT is a rare benign tumor with intermediate biologic potential,which has the potential of local invasion and recurrence.It is better to avoid unnecessary repeated biopsy.The main treatment is radical resection.The prognosis is good,but the patients should be followed closely postoperative in order to find recurrence as soon as possible.