Department of Maxillofacial and Plastic Surgery, Hôpital Universitaire Necker-Enfants Malades, 75015, Paris, France.
Department of Pathology, Hôpital Universitaire Necker-Enfants Malades, 75015, Paris, France; Université Paris Descartes, 75006, Paris, France.
J Craniomaxillofac Surg. 2018 Feb;46(2):201-206. doi: 10.1016/j.jcms.2017.12.001. Epub 2017 Dec 12.
Melanotic neuroectodermal tumor of infancy (MNTI) of the head and neck is a rare entity with uncertain clinical behavior. Radical surgical resection is the current recommended treatment, however this can cause severe aesthetic and functional sequelae. The aim of this study was to clinically characterize MNTIs and to stratify risk factors that may influence locoregional recurrence.
A retrospective multicenter study, including 11 patients from eight centers with a confirmed diagnosis of MNTI, was conducted. Epidemiological, clinical, radiological, pathological, and immunohistochemical examinations were reviewed. A statistical analysis using a t-test was conducted to calculate parameters correlating with tumor recurrence.
MNTIs mainly occurred in the maxilla, with a mean age at diagnosis of 3.18 months (range: 0-6 months). Primary surgery was performed on 10 patients, with a clear margin resection on two patients. Overall recurrence rate was 27% with a survival of 100% at time of follow-up. No statistical correlation between recurrence rate, age at diagnosis, localization, resection margins, and pathological and immunohistochemical characteristics could be established.
In our study, locoregional tumor recurrence did not seem to correlate with resection margins, so a conservative surgical approach may need to be considered to avoid functional and aesthetic sequelae.
头颈部婴儿黑色素神经外胚层肿瘤(MNTI)是一种罕见的实体肿瘤,其临床行为不确定。目前推荐的治疗方法是根治性手术切除,但这可能会导致严重的美容和功能后遗症。本研究旨在对 MNTI 进行临床特征分析,并对可能影响局部区域复发的危险因素进行分层。
进行了一项回顾性多中心研究,包括来自八个中心的 11 名经确诊的 MNTI 患者。对流行病学、临床、影像学、病理学和免疫组织化学检查进行了回顾。使用 t 检验进行了统计学分析,以计算与肿瘤复发相关的参数。
MNTI 主要发生在上颌骨,诊断时的平均年龄为 3.18 个月(范围:0-6 个月)。10 名患者接受了初次手术,其中 2 名患者进行了明确的边缘切除。总的复发率为 27%,随访时的生存率为 100%。复发率与诊断时的年龄、定位、切除边缘、病理和免疫组织化学特征之间无统计学相关性。
在我们的研究中,局部区域肿瘤复发似乎与切除边缘无关,因此为避免功能和美容后遗症,可能需要考虑采用保守的手术方法。