临床误诊误治
臨床誤診誤治
림상오진오치
CLINICAL MISDIAGNOSIS & MISTHERAPY
2014年
12期
71-74
,共4页
刘娅%郭红光%宁浩勇%李进让
劉婭%郭紅光%寧浩勇%李進讓
류아%곽홍광%저호용%리진양
鼻腔%鼻窦%肌上皮癌%免疫组织化学
鼻腔%鼻竇%肌上皮癌%免疫組織化學
비강%비두%기상피암%면역조직화학
Nasal cavity%Nasal sinus%Myoepithelial carcinoma%Immunohistochemistry
目的:探讨鼻腔鼻窦肌上皮癌的诊治要点,防范误诊误治。方法对行手术切除的1例巨大鼻腔鼻窦肌上皮癌的临床资料进行回顾性分析,并复习国内外相关文献。结果本例为56岁男性,因左侧面部凸出巨大肿物3年余,肿物表面间断出血1个月入院。根据专科查体情况及鼻窦CT、MRI检查结果考虑来源于小涎腺的多形性腺瘤恶变或其他罕见肿瘤。经充分术前准备,包括多学科会诊、备足血源、术前肿瘤血管栓塞,术中完整切除一重3 kg、约24.5 cm ×16.0 cm ×12.0 cm大小的肿瘤。术后病理诊断:肌上皮癌(侵及鼻腔鼻窦)。结论鼻科医师应警惕单侧鼻腔鼻窦病变,加强对肌上皮癌病理特点及免疫组织化学的认识,以期对该病早诊断、早治疗。
目的:探討鼻腔鼻竇肌上皮癌的診治要點,防範誤診誤治。方法對行手術切除的1例巨大鼻腔鼻竇肌上皮癌的臨床資料進行迴顧性分析,併複習國內外相關文獻。結果本例為56歲男性,因左側麵部凸齣巨大腫物3年餘,腫物錶麵間斷齣血1箇月入院。根據專科查體情況及鼻竇CT、MRI檢查結果攷慮來源于小涎腺的多形性腺瘤噁變或其他罕見腫瘤。經充分術前準備,包括多學科會診、備足血源、術前腫瘤血管栓塞,術中完整切除一重3 kg、約24.5 cm ×16.0 cm ×12.0 cm大小的腫瘤。術後病理診斷:肌上皮癌(侵及鼻腔鼻竇)。結論鼻科醫師應警惕單側鼻腔鼻竇病變,加彊對肌上皮癌病理特點及免疫組織化學的認識,以期對該病早診斷、早治療。
목적:탐토비강비두기상피암적진치요점,방범오진오치。방법대행수술절제적1례거대비강비두기상피암적림상자료진행회고성분석,병복습국내외상관문헌。결과본례위56세남성,인좌측면부철출거대종물3년여,종물표면간단출혈1개월입원。근거전과사체정황급비두CT、MRI검사결과고필래원우소연선적다형성선류악변혹기타한견종류。경충분술전준비,포괄다학과회진、비족혈원、술전종류혈관전새,술중완정절제일중3 kg、약24.5 cm ×16.0 cm ×12.0 cm대소적종류。술후병리진단:기상피암(침급비강비두)。결론비과의사응경척단측비강비두병변,가강대기상피암병리특점급면역조직화학적인식,이기대해병조진단、조치료。
Objective To study the clinical characteristics, diagnosis and management of myoepithelial carcinoma in nasal cavity and nasal sinus;to prevent misdiagnosis or mistherapy. Methods Retrospectively analysis of the clinical data of a patient with giant myoepithelial carcinoma in nasal cavity undergoing surgical removal was made. Results The patient was a 56-year-old male with a giant massive protruding from his face for 3 years and intermittent hemorrhage for 1 month. After careful examination of the head and neck region and assaying the results of computer tomography ( CT) as well as magnetic resonance imaging ( MRI) , malignancy from pleomorphic adenoma in minor salivary glands or other rare tumors was suspec-ted. Sufficient preoperative preparations were performed, including multi-disciplinary consultation, sufficient volume of blood and transvascular embolization. The giant 3 kg mass of 24. 5 cm × 16. 0 cm × 12. 0 cm was successfully removed by surgery. The pathological diagnosis was myoepithelial carcinoma ( invading nasal cavity and sinus) . Conclusion Attention should be paid to unilateral nasal cavity and nasal sinus tumor;and immunohistochemistry is helpful for early diagnoses and therapy.