头颈部节细胞神经瘤11例临床分析

Clinical analysis of 11 cases of ganglioneuroma in head and neck

目的 探讨11例头颈部节细胞神经瘤(ganglioneuroma,GN)的临床特点、影像学、组织病理学特征、治疗及预后情况。方法 回顾性分析2011年1月~2021年6月在首都医科大学附属北京同仁医院接受诊治的10例及北京市顺义区妇幼保健院接受诊治的1例共11例头颈部GN患者的临床资料。结果 11例患者中,男女比例为1∶1.75,发病年龄范围15~59岁,中位年龄39岁。病变发生于颈部5例(45.4%)、颈胸交界处3例(27.3%)、颞区2例(18.2%)和蝶鞍区1例(9.1%)。3例无相关症状因体检发现来就诊,8例因体表肿物或压迫导致相关症状前来就诊。患者术前均接受CT或MRI检查,CT示病变不均匀强化或未见明显强化,MRI示病变呈等T1长T2信号,增强后病变明显强化。所有患者均接受手术治疗,术后病理结果诊断明确,免疫组化呈S-100(+)为100%(11/11),CD34(+)为72.7%(8/11)。所有患者均得到随访结果并均存活,无术后复发。结论头颈部GN是一种临床罕见的良性神经源性肿瘤,女性发病多于男性。该病的诊断建立在典型的组织病理学及免疫组化特征之上,临床表现及影像学检查有一定提示作用,首选治疗方式为手术,预后较好。

OBJECTIVE To explore the clinical,imaging,and histopathological features,treatment and prognosis of 11 cases of ganglioneuroma in head and neck.METHODS The data of total 11 cases of head and neck ganglioneuroma was analyzed retrospectively,which 10 patients were diagnosed and treated at Beijing Tongren Hospital,Capital Medical University,and 1 patient was diagnosed and treated at Shunyi District Maternal and Child Health Hospital,Beijing,from January 2011 to June 2021.RESULTS Among the 11 patients,the ratio of male to female was 1:1.75,the age ranged from 15 to 59 years old,and the median-age was 39 years old.The lesions of 5 cases(45.4%) occurred in the neck,3 cases(27.3%) in the cervical-thoracic junction,2 cases(18.2%) in the temporal area and 1 case(9.1%) in the sella area.Three cases without related symptoms went to see doctor because of physical examination findings,and symptoms caused by body surface masses or compression in another 8cases.All patients received CT or MRI examination.Uneven enhancement of the lesion or no obvious enhancement was shown in CT.Equal T1 and long T2 were shown and the lesion was significantly strengthened in MRI.All patients underwent surgical treatment.The diagnosis of the disease was made based on typical histopathological features and immunohistochemistry by 2pathologists,especially the positivity of S-100(+) number was 100%(11/11),and the CD34(+) number was 72.7%(8/11).All patients were followed-up and no recurrence occurred after surgery.CONCLUSION Ganglioneuroma in the head and neck was a rare clinical benign neurogenic tumor,more common in female than male.The diagnosis of the disease is based on typical histopathological and immunohistochemical characteristics.The clinical manifestations and imaging examinations have a certain hint.The first choice of treatment was surgery,and the prognosis was good.