Kösling S, Hintner M, Brandt S, Schulz Th, Bloching M
Klinik für Diagnostische Radiologie, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Strasse 16, D-06097 Halle, Germany.
Eur J Radiol. 2004 Jul;51(1):1-5. doi: 10.1016/j.ejrad.2003.09.002.
Mucoceles of the sphenoid sinus represent 1-2% of all paranasal sinus mucoceles. The aim of this paper is to report our experiences in patients with mucoceles of the sphenoid sinus.
In a period of 4 years, we observed six patients in whom a mucocele of the sphenoid sinus was suggested pre- or intraoperatively. Symptoms and signs included headache, visual loss and palsies of the III and VI cranial nerve. All patients were investigated by MRI and/or CT. Imaging findings were compared with operative and/or histological findings.
In three cases there were simple mucoceles, in one case we found a tumour (nasopharyngeal carcinoma) associated mucocele and in two cases, malignant tumours (carcinoma, chordoma) imitated a mucocele. The diagnosis of simple mucoceles was no problem at all by imaging. Difficulties made the two malignant tumours and the tumour associated mucocele. In the first two cases, repeated histological samples were necessary to make the final diagnosis.
Mucoceles of the sphenoid sinus should be investigated and handled very carefully with regard to differential diagnoses and tumour associated cases.
蝶窦黏液囊肿占所有鼻窦黏液囊肿的1% - 2%。本文旨在报告我们对蝶窦黏液囊肿患者的治疗经验。
在4年的时间里,我们观察了6例术前或术中提示有蝶窦黏液囊肿的患者。症状和体征包括头痛、视力丧失以及动眼神经和展神经麻痹。所有患者均接受了磁共振成像(MRI)和/或计算机断层扫描(CT)检查。将影像学检查结果与手术和/或组织学检查结果进行比较。
3例为单纯黏液囊肿,1例为伴有肿瘤(鼻咽癌)的黏液囊肿,2例为恶性肿瘤(癌、脊索瘤)酷似黏液囊肿。通过影像学检查诊断单纯黏液囊肿根本不成问题。难点在于那2例恶性肿瘤和伴有肿瘤的黏液囊肿。在前两例中,需要多次进行组织学取样才能做出最终诊断。
对于蝶窦黏液囊肿,在鉴别诊断和肿瘤相关病例方面应非常谨慎地进行检查和处理。