Al-Qahtani Aayed R, Di Lorenzo Maria, Yazbeck Salam
Department of Surgery, Hôpital Sainte-Justine, Montreal, Quebec, Canada.
J Pediatr Surg. 2003 May;38(5):733-6. doi: 10.1016/jpsu.2003.50195.
BACKGROUND/PURPOSE: Endobronchial tumors are rare in children and often misdiagnosed as benign conditions resulting in delayed definitive treatment. The authors reviewed their experience to highlight pertinent aspects of diagnosis and treatment.
A retrospective chart review was conducted of children with endobronchial tumors diagnosed between 1980 and 2002.
Nine patients had endobronchial tumors (5 girls, 4 boys), with average age of 13 years (range, 8.5 to 15 years). There were 5 carcinoid tumors, 3 mucoepidermoid carcinomas, and one pseudotumor. Preoperative bronchoscopic biopsy confirmed the diagnosis in 6 patients, was inconclusive in one, and not done in 2. All except one (pseudotumor) underwent surgical resection. Laser ablation was performed in 2 cases with complete cure in one. All had an uneventful postoperative course except one patient in whom ipsilateral pneumonia developed. Long-term follow-up was obtained with clinical examination, pulmonary x-ray, abdominal ultrasound scan, chest computed tomography scan, and serum 5-HIAA in those with carcinoid tumor. Bronchoscopy was performed twice yearly for the first 2 years, then yearly. No evidence of local or distant recurrence was reported.
Endobronchial lesions should be considered in children with persistent pneumonia despite adequate treatment or with undiagnosed respiratory symptoms. Prognosis is excellent with surgical resection. Specific follow-up protocol is recommended.
背景/目的：儿童支气管内肿瘤罕见，常被误诊为良性疾病，导致确定性治疗延迟。作者回顾其经验以突出诊断和治疗的相关要点。
对1980年至2002年间诊断为支气管内肿瘤的儿童进行回顾性病历审查。
9例患者患有支气管内肿瘤（5例女孩，4例男孩），平均年龄13岁（范围8.5至15岁）。其中有5例类癌肿瘤、3例黏液表皮样癌和1例假瘤。术前支气管镜活检确诊6例，1例结果不确定，2例未进行。除1例（假瘤）外均接受手术切除。2例进行激光消融，1例完全治愈。除1例发生同侧肺炎外，所有患者术后过程均顺利。对类癌肿瘤患者通过临床检查、肺部X线、腹部超声扫描、胸部计算机断层扫描和血清5-羟吲哚乙酸进行长期随访。最初2年每年进行2次支气管镜检查，之后每年1次。未报告局部或远处复发的证据。
对于经过充分治疗仍持续存在肺炎或有未确诊呼吸道症状的儿童，应考虑支气管内病变。手术切除预后良好。建议采用特定的随访方案。
