儿童声带颗粒细胞瘤2例临床特征分析

Clinical characteristics analysis of two cases of pediatric vocal cord granulosa cell tumor

目的:分析儿童声带颗粒细胞瘤(GCT)的临床特征。方法:回顾性分析2013年1月至2023年12月西安交通大学第二附属医院收治的2例儿童声带GCT患者的临床资料。结果:病例1,女,6岁,因“发声无力3月余”入院,喉镜提示声门下弥漫性膨隆,颈部增强CT提示前联合下方低密度结节并渐进性强化;患儿在全麻下行支撑喉镜CO_(2)激光切除术,术后病理确诊GCT;术后1个月至术后2年复查,肿物无复发,术区局部瘢痕形成,但无明显黏连,声门闭合可。病例2,女,11岁,因“声嘶半年余”入院,喉镜提示前联合光滑肿物,颈部增强CT及喉部增强MRI提示前联合强化结节;患儿在全麻下行支撑喉镜CO_(2)激光切除术,术后病理确诊GCT,术后2周至术后1年复查,肿物无复发,声门下瘢痕形成,声门闭合良好。结论:儿童声带GCT常表现为发音异常,需依靠病理确诊;手术切除为其主要治疗方法,术后应密切随访。

Objective:To analyze the clinical characteristics of granulosa cell tumor(GCT)in the vocal cords in children.Methods:The clinical data of 2 children with vocal cord GCT admitted to the Second Affiliated Hospital of Xi’an Jiaotong University from January 2013 to December 2023 were retrospectively analyzed.Results:Case 1,a 6-year-old female,was admitted with a chief complaint of vocal weakness for over 3 months.Under laryngoscopy,diffuse swelling was observed beneath the glottis.Enhanced CT of the neck indicated low-density nodules below the anterior commissure and progressive enhancement.The patient underwent CO_(2)laser resection under general anesthesia with a supportive laryngoscope,and the postoperative pathological diagnosis was GCT.The patient underwent follow-up examinations at 1 month and 2 years after surgery,and no recurrence of tumor was found,only local scars formed in the laryngeal cavity without obvious adhesions and with good glottal closure.Case 2,an 11-year-old female,was admitted with a chief complaint of hoarseness for over 6 months.Under laryngoscopy,a smooth mass was observed in the anterior commissure.Enhanced CT and MRI of the neck showed a nodular with enhancement in the anterior commissure.The patient underwent CO_(2)laser resection under general anesthesia with a supportive laryngoscope.The postoperative pathological diagnosis was GCT.Follow-up examinations at 2 weeks and 1 year after surgery showed no recurrence of tumor but scar formation under the glottis with good glottal closure.Conclusion:GCT of the vocal cords in children often presents with disordered voice production,which requires to be confirmed by pathological diagnosis.Surgical resection is the main treatment method,and close follow-up should be paid attention to after surgery.