Valentini Valentino, Nicolai Gianluca, Fabiani Francesco, Torroni Andrea, Pagnoni Mario, Battisti Andrea
Cattedra di Chirurgia Speciale Odontostomatologica, Università degli Studi di Roma Tor Vergata, Rome, Italy.
J Craniofac Surg. 2004 Jan;15(1):106-13. doi: 10.1097/00001665-200401000-00029.
Hemangiopericytoma is a rare vascular tumor featuring the uncontrolled proliferation of pericytes. This tumor tends to develop in subcutaneous tissue and skeletal muscle. The localization of hemangiopericytoma in the orbit is particularly rare. Clinical signs and symptoms are, in order of frequency, proptosis, perception of an intraorbital mass, pain, diplopia, reduction of visus, tumescence, and ecchymoses of the eyelids. Hemangiopericytomas have higher potential of relapse, local invasiveness, and the possibility of producing distant metastases. Surgery must be as radical as possible to avoid incomplete tumor resection and high frequency of relapse together with increased duration of the disease and a higher risk of malignant development. The current report is a study of two cases of hemangiopericytoma in the orbital cavity treated at the Unit of Maxillo-Facial Surgery of the University of "La Sapienza" in Rome. The present data demonstrate that complete en bloc excision of the mass with its capsule is important to avoid the risk of relapse. To this end, an appropriate first surgical treatment should be chosen so as to obtain a wide "surgical light" and complete view of the mass. In the reported cases, the use of a combined anterolateral approach was preferred to attack the tumor from different sides. Indeed, such an approach allows one to obtain optimal exposition of the orbital region and temporal and infratemporal fossae contemporaneously.
血管外皮细胞瘤是一种罕见的血管肿瘤，其特征是周细胞不受控制地增殖。这种肿瘤倾向于在皮下组织和骨骼肌中发生。血管外皮细胞瘤发生于眼眶极为罕见。临床体征和症状出现频率依次为眼球突出、眶内肿物感、疼痛、复视、视力下降、肿胀及眼睑瘀斑。血管外皮细胞瘤具有较高的复发、局部侵袭及远处转移可能性。手术必须尽可能彻底，以避免肿瘤切除不完全、高复发率、疾病病程延长及恶变风险增加。本报告是对罗马“La Sapienza”大学颌面外科治疗的两例眼眶腔血管外皮细胞瘤的研究。目前的数据表明，完整切除肿物及其包膜对于避免复发风险很重要。为此，应选择合适的首次手术治疗方法，以便获得广阔的“手术视野”并完整观察肿物。在报告的病例中，首选联合前外侧入路从不同侧面攻击肿瘤。实际上，这种入路能够同时实现对眶区以及颞下和颞下窝的最佳显露。
