Okumura Yuri, Nomura Kazuhiro, Oshima Takeshi, Kasajima Atsuko, Suzuki Takahiro, Ishida Eichi, Kobayashi Toshimitsu
Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-cho, Aoba-ku, Sendai, Miyagi 980-8574, Japan.
Case Rep Otolaryngol. 2013;2013:670105. doi: 10.1155/2013/670105. Epub 2013 Jul 10.
We report an extremely rare case of inflammatory myofibroblastic tumor of the posterior edge of the nasal septum. An 11-year-old boy presented with frequent epistaxis and nasal obstruction persisting for one year. Based on the clinical presentation and imaging studies, juvenile angiofibroma was suspected, but angiography suggested the possibility of another type of tumor. Transnasal endoscopic surgery found that the tumor protruded into the nasopharynx from the posterior end of the nasal septum. Histological examination identified spindle cells with immunoreaction for vimentin, smooth muscle actin, and anaplastic lymphoma kinase (ALK), but not for desmin and cytokeratin. This is a report of inflammatory myofibroblastic tumor mimicking juvenile angiofibroma. This case suggests that angiography is helpful in the differential diagnosis of epipharyngeal tumor in adolescence.
我们报告了一例极为罕见的鼻中隔后缘炎性肌纤维母细胞瘤病例。一名11岁男孩出现频繁鼻出血和鼻塞症状，持续了一年。根据临床表现和影像学检查，怀疑为青少年血管纤维瘤，但血管造影提示可能是另一种类型的肿瘤。经鼻内镜手术发现肿瘤从鼻中隔后端突入鼻咽部。组织学检查发现梭形细胞对波形蛋白、平滑肌肌动蛋白和间变性淋巴瘤激酶（ALK）呈免疫反应，但对结蛋白和细胞角蛋白无反应。本文报道了一例酷似青少年血管纤维瘤的炎性肌纤维母细胞瘤。该病例表明血管造影有助于青少年咽上肿瘤的鉴别诊断。
