摘要
目的探讨侵犯颅前、中窝的泪腺肿瘤的经颅眶入路手术方法及疗效。方法回顾性分析23例侵犯颅前、中窝的泪腺肿瘤的临床资料。23例中男15例，女8例，年龄2—76岁，平均42．5岁。病史2个月～27年，平均43个月。主要临床表现为眼球突出、局部疼痛。对所有病人均经颅眶入路进行手术切除肿瘤治疗。23例病人中腺样囊性癌11例，恶性混合瘤6例，泪腺腺癌2例，鳞癌1例，导管癌1例，肌上皮癌1例，良性混合瘤1例。对18例病人进行术后随访，时间为1个月至7年，平均35个月。结果术后4例病人上睑下垂；1例术后眼球固定、视力丧失。无手术死亡及其他手术并发症病人。随访结果：4例病人肿瘤复发，死于泪腺腺癌全身转移1例。结论泪腺恶性肿瘤，以腺样囊性癌最多见，易破坏颅骨，侵犯颅前、中窝，经颅眶入路可获得充分的眶尖减压和肿瘤显露。但肿瘤难以全切，容易复发，术后需放、化疗，预后不良。
Objective To investigate the clinical manifestations of lacrimal gland tumor involving the anterior and middle cranial fossae and the effect of transcranio-orbital approach in treatment of such tumor. Methods A retrospective study was conducted on the clinical data of 23 cases lacrimal gland tumor involving the anterior and middle cranial fossae confirmed by radiological examination, including 11 cases of adenoid cystic carcinoma, 6 cases of pleomorphic adenocarcinoma （ malignant mixed tumor）, 2 cases of adenocarcinoma, 1 case of squamous cell carcinoma, 1 case of ductal carcinoma, 1 case of mucoepidermoid carcinoma, and 1 case of benign mixed tumor, 15 males and 8 females, aged 42.5 （2 -76）, with a case history of 43 months （ 2 months to 27 years）, with the chief complaints of progressive proptosis, diskenesia of the eye ball, and orbit pain, all undergoing transcranio--orbital operation from August 1998 to February. 2006. Follow up was conducted for 1 month to 7 years. Results Postoperatively, ophthalmoplegia was found in 4 cases, and blindness in 1 case. There was no operative death or other significant complication. Recurrence of tumor occurred in 4 cases, and 1 case died from distant metastasis of adenocarcinoma. Conclusions Malignant lacrimal gland tumors, mainly adenoid cystic carcinomas, incline to involve the anterior and middle cranial fossae. Adequate orbital apex decompression and exposure of the tumor can result from suitable transcranio-orbital approach. However, complete surgical excision is difficult, and the tumor has a tendency to recur post-operatively. Suitable treatment strategy should by combination of operation with irradiation or chemotherapy. Prognosis is poor.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2006年第23期1597-1599,共3页
National Medical Journal of China
关键词
眼眶肿瘤
颅前窝
颅中窝
神经外科手术
Orbital Neoplasms
Cranial fossa, Anterior
Cranial fossa, Middle
Neurosurgical procedures
