颞骨巨细胞瘤的影像学特征、分期系统和外科治疗。
Imaging features, staging system, and surgical management of giant cell lesions of the temporal bone.
机构信息
Department of Otorhinolaryngology Head and Neck Surgery, Beijing Children's Hospital Capital Medical University, National Center for Children's Health, Beijing Key Laboratory for Pediatric Diseases of Otolaryngology-Head and Neck Surgery, Beijing, China.
College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Chinese PLA Medical School, National Clinical Research Center for Otolaryngologic Diseases, Key Lab of Hearing Impairment Science of Ministry of Education, Key Lab of Hearing Impairment Prevention and Treatment of Beijing, Beijing, China.
出版信息
Acta Otolaryngol. 2022 Jul-Aug;142(7-8):553-561. doi: 10.1080/00016489.2022.2099969. Epub 2022 Jul 25.
BACKGROUND
Giant cell tumors (GCTs) and giant cell granulomas (GCGs) are giant cell-rich lesions that occur extremely rarely in the temporal bone and have similar clinical presentations.
OBJECTIVES
We aimed to analyze the clinical features and introduce our staging system and surgical treatment.
METHODS
Forty-six patients pathologically diagnosed with a giant cell lesion involving the temporal bone between October 2001 and October 2020 were reviewed retrospectively. The clinical characteristics, surgical approaches, and risk factors for recurrence were analyzed.
RESULTS
GCTs and GCGs presented as masses centered on the temporomandibular joint with similar imaging features, including a thin, calcified shell and central scattered calcifications on a computed tomography scan. Differences were detected on magnetic resonance imaging in 29.6% (4/14) of GCG and 50% (16/32) of GCT cases; the remaining cases were not distinguishable. Based on our staging system and surgical strategy, 31.8% (7/22) of GCT and 10% (1/10) of GCG cases experienced recurrence, which compares to recurrence rates of 60% in GCT cases and 20% in GCG cases in previous studies.
CONCLUSIONS
Specific clinical and preoperative imaging features help to make a diagnosis of temporal giant cell-rich lesions. Our staging system and surgical strategy could help surgeons tailor the surgical strategy.
背景
巨细胞瘤（GCTs）和巨细胞肉芽肿（GCGs）是富含巨细胞的病变，在颞骨中极为罕见，且具有相似的临床表现。
目的
分析颞骨巨细胞病变的临床特征，并介绍我们的分期系统和手术治疗方法。
方法
回顾性分析 2001 年 10 月至 2020 年 10 月期间经病理诊断为颞骨巨细胞病变的 46 例患者的临床资料。分析其临床特征、手术入路和复发的危险因素。
结果
GCTs 和 GCGs 表现为以颞下颌关节为中心的肿块，影像学特征相似，包括薄层、钙化壳和 CT 扫描中央散在的钙化。29.6%（4/14）的 GCG 和 50%（16/32）的 GCT 病例在磁共振成像上存在差异，其余病例无法区分。根据我们的分期系统和手术策略，22.7%（7/22）的 GCT 和 10%（1/10）的 GCG 病例复发，而之前的研究中 GCT 病例的复发率为 60%，GCG 病例的复发率为 20%。
结论
特定的临床和术前影像学特征有助于诊断颞骨富含巨细胞的病变。我们的分期系统和手术策略可以帮助外科医生制定个性化的手术策略。
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