6例鼻腔鼻窦畸胎癌肉瘤临床及影像学表现

Clinical and imaging manifestations of sinonasal teratocarcinosarcoma:Report of 6 cases

目的观察鼻腔鼻窦畸胎癌肉瘤(SNTCS)临床及影像学表现。方法回顾性分析6例经病理确诊SNTCS的临床及影像学资料,均接受鼻窦MR平扫,其中5例接受增强MR检查,4例接受鼻窦CT平扫。结果6例中,男5例、女1例,年龄34~59岁、中位年龄53岁;临床主要表现为鼻衄和进行性鼻塞。影像学上,6例SNTCS均为鼻腔鼻窦单发病灶,边界不清、形态不规则,5个病灶中心位于鼻腔及筛窦、1个位于颅底嗅沟;平扫CT均表现为等或稍低密度不规则软组织肿块,伴溶骨性骨质破坏区;T1WI上,5个病灶呈等或稍低信号、1个呈低信号,4个内见斑片状低信号,1个瘤周见不规则高信号;6个病灶T2WI均呈略高信号,4个内见条纹状低信号、3个伴小囊变;增强后5个病灶均呈明显不均质强化,3个内见条纹状强化,均侵犯周围组织。结论SNTCS临床及影像学表现具有一定特异性,有助于诊断。

Objective To observe clinical and imaging manifestations of sinonasal teratocarcinosarcoma(SNTCS).Methods Clinical and imaging manifestations of 6 cases of SNTCS confirmed by pathology were retrospectively analyzed.All 6 patients underwent plain MR scanning of sinuses,among them 5 underwent enhanced MR and 4 underwent plain CT scanning.Results Among 6 patients with SNTCS,5 were male and 1 was female,aged from 34 to 59 years,with a median age of 53 years.The main symptoms were epistaxis and progressive nasal congestion.All 6 cases were found with singe sinonasal lesion present as irregular mass with unclear boundaries on images,5 located in nasal cavity and ethmoid sinuses and 1 in the skull base olfactory groove.On plain CT,the lesions present as irregular soft tissue masses with equal or slightly low densities,and bone destruction areas with bone lytic changes were noticed in all 4 cases.On plain T1WI,equal or slightly low signals were observed in 5 cases,while low signal was detected in 1 case.Patchy low signals were found in 4 lesions,while irregular high signals around the tumor were detected in 1 case.On plain T2WI,slightly hypersignals were found in all 6 lesions,while fringe hyposignals were noticed in 4 cases and with microcystic lesions in 3 cases.Enhanced MRI showed obvious heterogeneous enhancement of all 5 lesions,3 with fringe enhancement,all invaded surrounding tissue.Conclusion Clinical and imaging manifestations of SNTCS were certain specific,hence being helpful to diagnosis.