Wang Hongwu, Zhang Nan, Tao Meimei, Li Dongmei, Zhou Yunzhi, Zou Hang, Liang Sujuan, Li Jing
Minimal Invasive Tumor Therapy Center, Beijing Coal General Hospital, Beijing, China.
Tumori. 2012 Sep-Oct;98(5):581-7. doi: 10.1177/030089161209800507.
Malignant airway tumors in children have rarely been reported. We evaluated the safety and therapeutic effects of interventional bronchoscopic therapy in 8 children with malignant airway tumors.
We retrospectively analyzed 8 children with malignant airway tumors diagnosed by pathology, and evaluated their clinical features, chest computer tomography findings and bronchoscopic manifestations.
Two of the 8 pediatric patients had high-grade malignancies (lymphoma and sarcoma) and the others all had low-grade malignancies, including 2 cases with mucoepidermoid carcinoma and 4 cases with inflammatory myofibroblastic tumor. Their ages ranged from 4 to 8 years (mean, 5.7 ± 0.9). There were no specific clinical manifestations in the children, and all of them presented with various respiratory symptoms, including cough and gasping associated with hemoptysis. Chest CT indicated round intra-airway neoplasms. Obstructive pulmonary atelectasis occurred in the main bronchus of 4 patients (3 cases of the left main bronchus and 1 case of the right intermedius bronchus). All children (1 case with local anesthesia and 7 cases with general anesthesia) underwent interventional bronchoscopic therapy, including argon plasma coagulation and CO 2 cryosurgery. The success rate for the rigid procedures was 100.0% (7/7), and the cure rate after 3 months was 85.7% (6/7). A part of the tumor remained in the lung of 1 patient with inflammatory myofibroblastic tumor after bronchoscopic treatment. One patient with local anesthesia died of suffocation caused by tumor consolidation during the bronchoscopic procedure. There were no recurrences in 6 patients during the follow-up period. One recurred patient was cured at 6 months.
There are no specific manifestations in children with malignant airway tumors. Interventional bronchoscopic therapy seems to be safe and effective for those tumors under general anesthesia.
儿童恶性气道肿瘤鲜有报道。我们评估了介入性支气管镜治疗8例儿童恶性气道肿瘤的安全性和治疗效果。
我们回顾性分析了8例经病理诊断的儿童恶性气道肿瘤患者，评估了他们的临床特征、胸部计算机断层扫描结果和支气管镜表现。
8例儿科患者中，2例为高级别恶性肿瘤（淋巴瘤和肉瘤），其他均为低级别恶性肿瘤，包括2例黏液表皮样癌和4例炎性肌纤维母细胞瘤。他们的年龄在4至8岁之间（平均5.7±0.9岁）。儿童无特异性临床表现，均表现为各种呼吸道症状，包括咳嗽、喘息伴咯血。胸部CT显示气道内圆形肿物。4例患者的主支气管发生阻塞性肺不张（3例左主支气管，1例右中间支气管）。所有儿童（1例局部麻醉，7例全身麻醉）均接受了介入性支气管镜治疗，包括氩等离子体凝固术和二氧化碳冷冻治疗。硬质操作的成功率为100.0%（7/7）,3个月后的治愈率为85.7%（6/7）,1例炎性肌纤维母细胞瘤患者支气管镜治疗后肺部仍残留部分肿瘤。1例局部麻醉患者在支气管镜检查过程中死于肿瘤阻塞导致的窒息。6例患者在随访期间无复发。1例复发患者在6个月时治愈。
儿童恶性气道肿瘤无特异性表现。介入性支气管镜治疗在全身麻醉下对这些肿瘤似乎安全有效。
