鼻腔神经内分泌癌2例报告并文献复习

发布时间：2018-06-29 02:09

本文选题：鼻腔 + 神经内分泌癌　；参考：《浙江大学》2011年硕士论文

【摘要】：目的：本文结合2例鼻腔神经内分泌癌病例,复习国内外相关文献资料,分析和总结鼻腔神经内分泌癌的临床特征、发病诱因、病理表现、治疗及预后,以提高对鼻腔神经内分癌的认识,并为以后的临床工作提供帮助。方法：分析浙江大学附属第一医院耳鼻咽喉科2010年收治的2例鼻腔神经内分癌病例,查找美国国立图书馆PubMed.万方数据资源系统、维普期刊在线数据库的相关文献,进行文献复习。结果：病例1为62岁男性患者,临床表现为右鼻塞、鼻出血伴右侧鼻背部麻木感,查体见右侧鼻腔内充满灰白色新生物,CT示右侧上颌窦、筛窦、蝶窦、额窦及右鼻腔内广泛占位,增强明显。经鼻侧径路行肿瘤切除术,术后联合放化疗,目前随访7月未见肿瘤复发及转移,病理诊断为小细胞型神经内分泌癌。病例2为56岁男性患者,临床表现为左侧上唇、上颌窦区麻木伴左侧鼻塞,查体见左侧鼻底、鼻腔外侧壁、鼻咽部及左侧硬腭粘膜下隆起。MRI示左侧鼻腔、上颌窦及左侧鼻咽部异常信号,T1WI呈低信号,T2WI呈高信号,增强显示病灶明显不均匀强化。活检病理考虑神经内分泌癌,予放化疗治疗。已随访8个月未见肿瘤复发及转移。结论：鼻腔神经内分泌癌为罕见的鼻腔恶性肿瘤。其发病可能与辐射相关,临床表现多样化。诊断主要依靠组织病理学表现及免疫组化染色,CT及MRI影像学检查有助了解病变范围及性质。鼻腔神经内分泌癌的具体治疗及预后情况与分型相关。其中类癌经单纯手术治疗即可获得良好预后。非典型类癌手术范围较类癌广必要时可联合放疗或化疗,预后一般。小细胞神经内分泌癌恶性程度最高,多选择放化疗联合治疗,预后最差。
[Abstract]:Objective: to review the literature of 2 cases of neuroendocrine carcinoma of nasal cavity, and to analyze and summarize the clinical features, pathogenesis, pathological manifestation, treatment and prognosis of neuroendocrine carcinoma of nasal cavity. In order to improve the understanding of nasal nerve cancer, and provide help for clinical work in the future. Methods: two cases of nasal nerve cancer were analyzed in the Department of Otorhinolaryngology, the first affiliated Hospital of Zhejiang University in 2010. Wanfang data Resource system, the related literature of WIP journal online database, literature review. Results: case 1 was a 62-year-old male. The clinical manifestations were right nasal obstruction, epistaxis with right nose and back numbness. The right nasal cavity was filled with grayish white neo-biologic CT scan showing the right maxillary sinus, ethmoid sinus, sphenoid sinus, right maxillary sinus, ethmoid sinus and sphenoid sinus. The frontal sinus and the right nasal cavity occupy a wide range of space, the enhancement is obvious. Tumor resection was performed via nasal approach combined with radiotherapy and chemotherapy. No recurrence or metastasis of the tumor was found during the follow-up period of 7 months and the pathological diagnosis was small cell neuroendocrine carcinoma. Case 2 was a 56-year-old male. The clinical manifestations were left upper lip, numbness of maxillary sinus region with left nasal obstruction, left nasal floor, lateral wall of nasal cavity, submucosal eminence of nasopharynx and left hard palate. MRI showed left nasal cavity. The abnormal signal intensity of maxillary sinus and left nasopharynx showed low signal intensity on T _ 1WI and high signal intensity on T _ 2WI. Neuroendocrine carcinoma was taken into account in biopsy and pathology and was treated with radiotherapy and chemotherapy. No tumor recurrence or metastasis was found after 8 months follow-up. Conclusion: neuroendocrine carcinoma of nasal cavity is a rare malignant tumor of nasal cavity. The disease may be related to radiation and its clinical manifestations are diverse. The diagnosis mainly depends on histopathological findings and immunohistochemical staining CT and MRI imaging to help understand the extent and nature of the lesions. The specific treatment and prognosis of neuroendocrine carcinoma of nasal cavity are related to classification. Among them, carcinoid can obtain good prognosis by simple surgical treatment. Atypical carcinoid surgery is more extensive than carcinoid, if necessary combined with radiotherapy or chemotherapy, the prognosis is mediocre. The malignant degree of small cell neuroendocrine carcinoma is the highest and the prognosis is the worst.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R739.63

【共引文献】