Yang H M, Yin J, Li G, Liu X C
Department No.2 of Respiratory Diseases, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China.
Department of Radiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China.
Zhonghua Er Ke Za Zhi. 2021 Jan 2;59(1):27-32. doi: 10.3760/cma.j.cn112140-20200904-00849.
To summarize the clinical manifestations and to evaluate the feasibility of therapeutic bronchoscopy in pediatric primary airway tumors. The clinical data of 8 children presented with airway tumors in Beijing Children's Hospital from November 2016 to March 2018 were retrospectively analyzed. Descriptive analysis was used to summarize the outcome and prognosis of these children after interventional bronchoscopy. Among the 8 children, 5 were male and 3 were female, aged from 4 years and 8 months to 9 years and 2 months. The main clinical manifestations were cough and wheezing in 6 cases, hemoptysis in 3 cases and recurrent pulmonary infection in 2 cases, and none of them had lymph node metastasis and extra-pulmonary metastasis. All 8 children underwent bronchoscopic resection of the tumors, and the 4 children with blood-rich tumors had bronchial artery embolization at the blood supply site before the resection. No major bleeding or pneumothorax occurred during or after the operation. Four cases had low grade malignant bronchial mucoepidermoid carcinoma, 2 had inflammatory myofibroblastoma, and the rest two had pleomorphic adenoma and bronchial smooth muscle spindle cell tumor. Postoperative follow-up lasted 2 to 4 years, and 3 had tumor recured. Among the 3 cases, 2 had inflammatory myofibroblastoma who underwent surgical resection of the lesion and combined chemotherapy, respectively; and one had mucoepidermoid carcinoma who was under follow-up after interventional cryotherapy. The clinical manifestations of primary airway tumors in children are atypical. The main clinical manifestations are dry cough, wheezing, recurrent pulmonary infection and hemoptysis. Interventional bronchoscopy is a feasible choice for the treatment of pediatric airway tumors.
总结小儿原发性气道肿瘤的临床表现，并评估治疗性支气管镜检查在小儿原发性气道肿瘤中的可行性。回顾性分析2016年11月至2018年3月在北京儿童医院就诊的8例气道肿瘤患儿的临床资料。采用描述性分析总结这些患儿介入性支气管镜检查后的结局及预后。8例患儿中，男5例，女3例，年龄4岁8个月至9岁2个月。主要临床表现为咳嗽、喘息6例，咯血3例，反复肺部感染2例，均无淋巴结转移及肺外转移。8例患儿均接受了肿瘤的支气管镜切除，其中4例血供丰富的肿瘤患儿在切除前于血供部位行支气管动脉栓塞术。术中及术后均未发生大出血或气胸。4例为低级别恶性支气管黏液表皮样癌，2例为炎性肌纤维母细胞瘤，其余2例为多形性腺瘤和支气管平滑肌梭形细胞瘤。术后随访2至4年，3例肿瘤复发。其中2例炎性肌纤维母细胞瘤分别接受了病变手术切除及联合化疗；1例黏液表皮样癌接受介入冷冻治疗后随访。小儿原发性气道肿瘤临床表现不典型，主要表现为干咳、喘息、反复肺部感染及咯血。介入性支气管镜检查是治疗小儿气道肿瘤的可行选择。
