恶性颈动脉体瘤七例诊治分析  

Diagnostic and therapeutic analysis of malignant carotid body tumors

作　　者：连利珊[1] 刘昌伟[1] 管珩[1] 郑曰宏[1] 刁永鹏[1] 郭李龙[1] 李拥军[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院血管外科,100730

出　　处：《中华医学杂志》2014年第11期828-831,共4页National Medical Journal of China

摘　　要：目的 探讨恶性颈动脉体瘤的诊断、治疗及预后.方法 对北京协和医院自1949年12月至2012年12月收治的7例恶性颈动脉体瘤患者临床及病理资料进行回顾性分析.结果 7例恶性颈动脉体瘤中,2例未行瘤体切除.5例行瘤体切除,其中瘤体切除加颈外动脉结扎4例,瘤体切除加颈内动脉大隐静脉重建1例.术中喉返神经损伤2例,舌下神经损伤3例,喉返、舌下及交感神经均损伤1例,无脑梗死发生.随访2～12年,1例术后2年同侧复发,术后5年出现多处骨及胰腺转移,术后7年死亡.1例术后1年出现术侧颈内动脉重度狭窄,行颈动脉内支架植入术治疗.2例未行瘤体切除的患者均健在,1例放疗后瘤体稳定,1例随访8年因症状加重行瘤体切除术.结论 恶性颈动脉体瘤应结合病理结果和生物学行为综合进行诊断,早期发现及早期手术治疗可降低恶性颈动脉体瘤的局部浸润及远处转移,放疗可以有效的控制局部瘤体生长和转移.Objective To analyze the diagnosis, treatment and prognosis of the malignant carotid body tumor. Methods The data of pathology, diagnosis, therapy and follow-up of seven patients with malignant carotid body tumor in Peking Union Medical College Hospital from Dec 1949 to Dee 2012 were analyzed retrospectively. Results 2 cases without the tumor resection. 5 cases were treated with surgical methods, 4 cases with tumor resection and external carotid artery ligation, 1 case with tumor resection and reconstruction of internal carotid artery with saphenous vein. Cranial nerve palsy occurred in 5 cases, of which 3 occurred hypogiossal nerve damage, 2 cases occurred vagus damage, 1 case with hypogiossal,vagus and sympathetic nerve damage. Follow-up was from 2 to 12 years, local tumor recurrence happened in 2-year postoperation and got remote bone and pancreas metastasis in 5-year postoperation in one case, and finally died in 7-year postoperation. 1 case had the internal carotid artery restenosis severely in 1-year postoperation, then performed the stent treatment. 2 cases without operation were still alive. Interestingly, the tumor after radiotherapy was steady in one case. The other received the tumor resection because of the severe syndrome after 8 years. Conclusion the diagnosis of malignant carotid body tumor should base on occurring extensive invasion of adjacent organs, metastasis and pathology. Early stage surgical excision can reduce the recurrence and complication. Radiotherapy can effectively control local size and distant metastasis.

关 键 词：恶性颈动脉体瘤 诊断 放疗 预后 

分 类 号：R739.91[医药卫生—肿瘤]