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中耳神经内分泌肿瘤:不可预测的肿瘤行为和复发倾向。

Neuroendocrine neoplasms of the middle ear: Unpredictable tumor behavior and tendency for recurrence.

机构信息

Department of Otolaryngology - Head and Neck Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.

Department of Head and Neck Surgical Oncology, University Medical Center Utrecht Cancer Center, Utrecht, The Netherlands.

出版信息

Head Neck. 2021 Jun;43(6):1848-1853. doi: 10.1002/hed.26658. Epub 2021 Feb 19.

Abstract

BACKGROUND

Middle ear adenomatous neuroendocrine tumors (MEANTs) are rare temporal bone tumors. This study evaluates its clinical behavior and therapy outcome.

METHOD

Retrospective case review in a tertiary referral center evaluating histopathology, immunohistochemistry, treatment, and outcome.

RESULTS

Nine patients were diagnosed with MEANT. One patient presented with locally invasive tumor and underwent extensive en-bloc tumor resection with adjuvant radiotherapy. Seven of eight patients with locally non-aggressive tumor confined to the tympanomastoid space underwent tumor resection. Two patients were disease-free, five presented recurrence, even after apparent successful surgery. All tumors showed neuroendocrine features. Histopathology and immunohistochemistry did not yield prognostic tumor characteristics.

CONCLUSION

MEANTs are rare tumors with uncertain biological behavior and subsequent unpredictable clinical course. The preferred treatment is complete surgical tumor resection. They have a high tendency for recurrence, irrespective of negative intermediary surgery. As of yet, there are no prognostic biomarkers, including histopathology and immunohistochemistry.

摘要

背景

中耳腺样神经内分泌肿瘤(MEANT)是一种罕见的颞骨肿瘤。本研究评估其临床行为和治疗结果。

方法

在一家三级转诊中心进行回顾性病例分析,评估组织病理学、免疫组织化学、治疗和结果。

结果

9 名患者被诊断为 MEANT。1 名患者表现为局部侵袭性肿瘤,接受了广泛的整块肿瘤切除术和辅助放疗。8 名局限于鼓室乳突腔的局部非侵袭性肿瘤患者中,有 7 名接受了肿瘤切除术。2 名患者无疾病,5 名患者即使在明显成功的手术后也出现了复发。所有肿瘤均显示神经内分泌特征。组织病理学和免疫组织化学未得出具有预后意义的肿瘤特征。

结论

MEANT 是一种生物学行为不确定、随后临床过程不可预测的罕见肿瘤。首选治疗方法是完全手术切除肿瘤。它们有很高的复发倾向,与中间手术的阴性结果无关。到目前为止,还没有预后生物标志物,包括组织病理学和免疫组织化学。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5947/8248245/ff8886f4a1ce/HED-43-1848-g001.jpg

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