State Key Laboratory of Oncology in South China, Department of Radiology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, PR China.
Eur J Radiol. 2011 Nov;80(2):607-11. doi: 10.1016/j.ejrad.2011.02.008. Epub 2011 Feb 26.
We aimed to analyze the computed tomography (CT) and magnetic resonance imaging (MRI) findings of peripheral primitive neuroectodermal tumor (pPNET) of the head and neck.
Eight patients with pPNET of the head and neck confirmed by histopathological examination were analyzed retrospectively.
The average patient age was 8 years. The tumor location in the 8 patients was as follows: maxillofacial region (right, 2; left, 1), left maxillary sinus (1), right masticator space (1), left carotid space (1), right infratemporal fossa (1), and left parotid gland (1). All 5 patients who underwent CT demonstrated ill-defined soft masses and no calcification. Three patients with tumors in the maxillofacial region showed homogeneous small masses and a mild enhancement. The patient with left maxillary sinus tumor showed a heterogeneous mass with patchy, necrotic foci and mild heterogeneous enhancement. The patient with right masticator space tumor showed a heterogeneous mass, and marked heterogeneous enhancement. The T1-weighted images of the patients with right infratemporal fossa, left carotid space, and left parotid gland tumors were isointense. The T2-weighted images were heterogeneous and mildly hyperintense in 2 patients and hyperintense in 1 patient. Heterogeneous intermediate enhancement was demonstrated in 2 patients and mild ring enhancement in 1 patient.
The imaging features of pPNET of the head and neck are non-specific. An ill-defined, aggressive mass and variable enhancement on CT and MR images may suggest the diagnosis of pPNET. Peripheral PNET should be included in the differential diagnosis of children and adolescents' regional tumors.
分析头颈部外周原始神经外胚层肿瘤(pPNET)的计算机断层扫描(CT)和磁共振成像(MRI)表现。
回顾性分析 8 例经组织病理学检查证实的头颈部 pPNET 患者。
8 例患者的平均年龄为 8 岁。肿瘤位置如下:颌面区域(右侧 2 例,左侧 1 例)、左侧上颌窦(1 例)、右侧咀嚼肌间隙(1 例)、左侧颈动脉间隙(1 例)、右侧颞下窝(1 例)和左侧腮腺(1 例)。所有 5 例行 CT 检查的患者均表现为边界不清的软组织肿块,无钙化。3 例颌面区域肿瘤患者表现为均匀的小肿块,轻度强化。左侧上颌窦肿瘤患者表现为不均匀肿块,伴有斑片状、坏死灶,轻度不均匀强化。右侧咀嚼肌间隙肿瘤患者表现为不均匀肿块,明显不均匀强化。右侧颞下窝、左侧颈动脉间隙和左侧腮腺肿瘤患者的 T1 加权图像呈等信号。T2 加权图像 2 例呈混杂信号,轻度高信号,1 例呈高信号。2 例表现为混杂中度强化,1 例表现为轻度环状强化。
头颈部 pPNET 的影像学特征不具有特异性。CT 和 MRI 图像上边界不清、侵袭性肿块和不同程度的强化可能提示 pPNET 的诊断。外周 PNET 应纳入儿童和青少年区域性肿瘤的鉴别诊断。