背景:血管外皮细胞瘤是一种罕见的鼻窦肿瘤。其临床行为是有争议的。虽然有些人描述了一个懒惰的过程,其他人认为这是一种侵袭性病变,有快速局部复发的趋势。这里,我们描述了我们在治疗鼻中血管外皮细胞瘤(SN-HPC)方面的经验,将我们的经验与当前的文献进行比较,并评估体征和工具,以改善诊断和治疗。
方法:从我们的机构电子病历中提取并审查了2010年至2020年的所有SN-HPC病例。使用系统评价和荟萃分析(PRISMA)指南的首选报告项目,在系统文献综述中分析了PubMed和EMBASE在2010年至2020年之间的SN-HPC病例。有关人口统计的数据,介绍,诊断,治疗,并收集了结果。
结果:我们在我们机构中确定了4例鼻腔内的SN-HPC病例,在以前的报告中又发现了53例。诊断时的平均年龄是59岁,男女比例为1.2:1。SN-HPC大多是单方面出现的,出现在筛窦(42.1%)。最常见的症状是鼻出血(47.3)和鼻塞(47.3%)。诊断和定制治疗计划都需要计算机断层扫描(CT)和磁共振成像(MRI)。85.9%的患者采用内镜手术切除,在15.7%中,进行了额外的术前栓塞,与1例患者(2.6%)的间隔坏死有关。复发率为7%。
结论:尽管以前的报告将侵袭性肿瘤行为归因于SN-HPC,我们的经验和文献综述支持内镜下完全切除后更缓慢且复发率低.术前栓塞在某些情况下可能是有用的,但由于潜在的并发症,它不应该例行指出。
BACKGROUND: Hemangiopericytoma is a rare tumor of the sino-nasal tract. Its clinical behavior is controversial. Whereas some describe an indolent course, others consider it to be an aggressive lesion with a tendency toward rapid local recurrence. Here, we describe our experience in the management of sino-nasal hemangiopericytoma (SN-HPC), comparing our experience with the current literature, and evaluating signs and tools to improve diagnosis and treatment.
METHODS: All cases of SN-HPC between 2010 and 2020 were extracted and reviewed from our institutional electronic medical records. SN-HPC cases from PubMed and EMBASE between 2010 and 2020 were analyzed in a systematic literature
review using the preferred reporting items for systematic
review and meta-analysis (PRISMA) guidelines. Data regarding demographics, presentation, diagnosis, treatment, and outcome were collected.
RESULTS: We identified four cases of SN-HPC in the nasal cavity in our institution and an additional 53 cases in previous reports. The mean age at the time of diagnosis was 59 years, with a 1.2:1 male to female ratio. SN-HPC mostly appears unilaterally, arising in the ethmoid sinus (42.1%). The most common presenting symptoms were epistaxis (47.3) and nasal obstruction (47.3%). Both computed tomography (CT) and magnetic resonance imaging (MRI) were required for diagnosis and for tailoring the treatment plan. Endoscopic surgical excision was used in 85.9% of the patients, and in 15.7%, an additional preoperative embolization was performed, which was associated with septal necrosis in one patient (2.6%). The recurrence rate was 7%.
CONCLUSIONS: Although previous reports attribute an aggressive tumoral behavior to SN-HPC, our experience and the literature
review support a more indolent course with low recurrence rates following complete endoscopic resection. Preoperative embolization can be useful in certain cases, but due to potential complications, it should not be routinely indicated.