Friedman A D, Burns J A, Lutch M J, Zeitels S M
Department of Surgery, Harvard Medical School, Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
J Laryngol Otol. 2012 Jul;126(7):706-13. doi: 10.1017/S0022215112000928. Epub 2012 May 25.
The differential diagnosis of endolaryngeal mesenchymal neoplasms includes a wide spectrum of benign and malignant pathologies, which have been rarely photo-documented and assessed as a group.
Non-epithelial neoplasms of the endolarynx seen at our centre from 2002 to 2011 (n = 38; 36 treated at our institution) were retrospectively reviewed, with attention to clinical presentation, radiographic imaging, operative management, histology, and pre- and post-operative endoscopy. Submucosal squamous cell carcinomas, mucosal cysts, amyloid and Teflon granulomas were excluded.
Twenty-three of a total of 36 patients underwent definitive endoscopic surgical treatment. Supraglottic pathologies included lymphoma, lipoma, neuroendocrine carcinoma, lymphangioma, oncocytoma, haemangioma, synovial cell sarcoma and benign spindle cell neoplasm. Transglottic pathologies included synovial cell sarcoma and granular cell tumour. Glottic pathologies included granular cell tumour, osteoma, rhabdomyoma, rhabdomycosarcoma and myofibroblastic sarcoma. Subglottic pathologies included chondrosarcoma, neurofibroma, adenoid cystic carcinoma and vascular malformation.
The site of origin, degree of malignant behaviour and sensitivity to adjuvant treatment determined the course of surgical management, i.e. endolaryngeal versus transcervical, and limited removal versus wider resection.
喉内间质性肿瘤的鉴别诊断包括一系列广泛的良性和恶性病变,而这些病变作为一个整体很少有影像学记录和评估。
回顾性分析了2002年至2011年在我们中心所见的喉内非上皮性肿瘤(n = 38;其中36例在本机构接受治疗),重点关注临床表现、影像学检查、手术治疗、组织学以及术前和术后的内镜检查。排除了黏膜下鳞状细胞癌、黏膜囊肿、淀粉样变和聚四氟乙烯肉芽肿。
36例患者中有23例接受了确定性内镜手术治疗。声门上病变包括淋巴瘤、脂肪瘤、神经内分泌癌、淋巴管瘤、嗜酸性细胞瘤、血管瘤、滑膜肉瘤和良性梭形细胞瘤。声门旁病变包括滑膜肉瘤和颗粒细胞瘤。声门病变包括颗粒细胞瘤、骨瘤、横纹肌瘤、横纹肌肉瘤和肌纤维母细胞肉瘤。声门下病变包括软骨肉瘤、神经纤维瘤、腺样囊性癌和血管畸形。
肿瘤的起源部位、恶性行为程度以及对辅助治疗的敏感性决定了手术治疗的方式,即喉内手术与经颈手术,以及有限切除与广泛切除。