【罕见颞骨恶性肿瘤的诊断与治疗】。

Liming Gao, Wenyang Zhang, Yin Xia
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摘要

目的:分析颞骨罕见恶性肿瘤的诊断、治疗及预后。方法:回顾2014年3月至2020年12月我院收治的4例罕见颞骨恶性肿瘤,其中软骨肉瘤2例,纤维肉瘤1例,内淋巴囊状乳头状腺癌1例。三男一女,手术时年龄在28至56岁之间。常见症状包括听力丧失、面部麻痹、耳鸣和头痛。所有患者均接受影像学检查以评估病变的程度。采用颞骨次全切除或颞下窝入路切除肿瘤,必要时行术后辅助放疗。结果:2例软骨肉瘤患者中1例经肿瘤完全切除75个月治愈,另1例首次切除肿瘤后复发,再次行颞下窝入路颅底肿物切除术,112个月未复发。一例纤维肉瘤患者手术后存活28个月,切缘阳性,术后放疗。1例内淋巴囊状乳头状腺癌患者在次全取石12个月后复发,再次行颞骨次全切除并联合放疗。63个月无复发。结论:罕见颞骨恶性肿瘤发病率极低,部位隐匿,症状不典型。应注意早发现、早治疗。手术切除为主要治疗方法,晚期或切缘阳性时可辅以放疗。
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[Diagnosis and treatment of rare malignant temporal bone tumors].

Objective:To analyze the diagnosis, treatment and prognosis of patients with rare malignant tumors of the temporal bone. Methods:Four cases of rare temporal bone malignant tumors in our hospital between March 2014 and December 2020 were reviewed, including two cases of chondrosarcoma, one case of fibrosarcoma and one case of endolymphatic cystic papillary adenocarcinoma. There were three males and one female, ages between 28 and 56 years at the time of surgery. Common symptoms included hearing loss, facioplegia, tinnitus, and headache. All patients underwent imaging examinations to evaluate the extent of the lesions. Tumors were removed by subtotal temporal bone resection or infratemporal fossa approach, and postoperative adjuvant radiotherapy was applied if necessary. Results:One of the two chondrosarcoma patients was cured by complete resection of the tumor for 75 months, the other one recurred after the first excision of the tumor and underwent infratemporal fossa approach resection of skull base mass again with no recurrence found yet for 112 months. One patient with fibrosarcoma survived for 28 months after surgery with a positive margin and post-operative radiotherapy. One patient with endolymphatic cystic papillary adenocarcinoma recurred 12 months after subtotal lithotomy, and underwent subtotal temporal bone resection again, combined with radiotherapy. No recurrence was found for 63 months. Conclusion:The incidence of rare temporal bone malignant tumors is extremely low, the location is hidden, and the symptoms are atypical. Attention should be paid for early detection and early treatment. Surgical resection is the main treatment, and radiotherapy can be supplemented in the advanced stage or with a positive margin.

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