眼外肌内肿瘤的诊断治疗及预后分析  

Diagnosis and management of the tumors of extraocular muscles

作　　者：王毅[1] 朱慧[1] 赵海萍[1] 黑砚[1] 肖利华[1] 

机构地区：[1]武警总医院眼眶病研究所,北京100039

出　　处：《中华眼科杂志》2009年第1期56-60,共5页Chinese Journal of Ophthalmology

摘　　要：目的了解眼外肌内肿瘤的种类、临床表现及诊治方法。方法回顾性系列病例研究。收集经病理学确诊的11例眼外肌内肿瘤患者资料，分析其临床表现、影像学征象、治疗与预后情况。结果眼外肌内肿瘤病种包括：纤维瘤病3例，肌间血管瘤和颗粒细胞瘤各2例，横纹肌肉瘤、转移性腺癌、淋巴瘤和炎性肌纤维母细胞瘤各1例。眼球运动障碍、眼球突出和移位是其常见体征。CT和MRI等影像学检查可显示肌肉形态改变，肌肉可呈梭形、球形和不规则形增粗，直径均超过1cm。累及下直肌、内直肌、外直肌和下斜肌。根据累及肌肉的不同采用不同手术进路。病理结果是制定治疗方案的依据。结论眼外肌内肿瘤病种多样，临床表现和影像学检查有特征性，应积极活检明确病理诊断，预后与治疗方案的选择以及肿瘤性质有关。Objective To evaluate the spectrum, clinical features, diagnostic methods and treatment of the tumors of extraocular muscles. Methods In a retrospective case series study, the records of 11 consecutive cases with tumors of the extraocular muscles confirmed by pathologic examination were analyzed with special attention to the clinical manifestations, imaging findings, treatment and prognosis. Results There were fibromatosis in 3 cases, intermascular hemangioma and granular cell tumor both in 2 cases, inflammatory myofibroblastic tumor, rhabdomyosarcoma, T cell lymphoma and metastatic adenocarcinoma all in 1 case. The most frequent symptoms were limited ocular movement, exophthalmos and ocular displacement. In respect to images of computed tomography or magnetic resonance imaging, the configuration of the extraocular muscles with tumors demonstrated 3 patterns, fusiform, globular and irregular. The tumors that involved inferior, medial and lateral rectus muscles, and inferior oblique muscle, their maximal diameters all exceeded 1 cm. Depending on the involved muscles, different operative approaches were applied. The choice of treatments was determined by the pathology of the tumors. Conclusions The spectrum, clinical features and imaging findings of the tumors of extraocular muscles are unique. Earlier biopsy is important. The prognosis is correlated with treatments and the characteristic of tumors.

关 键 词：眼肿瘤 肿瘤 肌组织 诊断 治疗 预后 

分 类 号：R686[医药卫生—骨科学]