鼻腔鼻窦黏液性错构瘤:单机构病例系列研究并结合文献回顾

Sinonasal seromucinous hamartoma: a single institution case series combined with a narrative review of the literature.

机构信息

Department of Otorhinolaryngology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.

The Airway Mucus Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.

出版信息

Eur Arch Otorhinolaryngol. 2024 Oct;281(10):5311-5317. doi: 10.1007/s00405-024-08759-x. Epub 2024 May 30.

Abstract

PURPOSE

This study aimed to investigate the clinical and histopathological characteristics of sinonasal seromucinous hamartomas (SHs).

METHODS

Eight patients with sinonasal SH and treated at a tertiary hospital between November 2005 and September 2023 were included. Additionally, a systematic review of published articles was conducted, analyzing 48 cases of SH described in the literature.

RESULTS

Among the eight patients treated at our institution, tumors originated from the posterior nasal cavity in four patients and middle turbinate and middle meatus were the primary origin in two patients each. Coexistence of inflammatory nasal polyps (NPs) was observed in four cases. Histopathologically, four patients exhibited focal respiratory epithelial adenomatoid hamartoma (REAH) features, and low-grade dysplasia was found in one patient. A combined analysis with previous literature revealed that 46.3% of all cases originated in the anterior nasal cavity. The proportions of cases accompanied by NPs and those with focal REAH features were 20.5% and 39.1%, respectively. Additionally, the frequencies of cases exhibiting dysplastic features (5.4%) and recurrence (2.1%) were low. Remarkably, tumors originating from the anterior region tended to have a higher frequency of dysplasia than those originating from the posterior region, although this difference was not statistically significant (p = 0.0996).

CONCLUSION

Patients with sinonasal SH showed favorable treatment outcomes following surgical resection. Focal REAH features and accompanying NPs were frequently observed. A substantial proportion of cases originate in the anterior nasal cavity, and these tumors may exhibit a high tendency for dysplasia.

摘要

目的

本研究旨在探讨发生于鼻腔鼻窦的黏膜黏液性错构瘤(SH)的临床和组织病理学特征。

方法

本研究纳入了 2005 年 11 月至 2023 年 9 月在一家三级医院接受治疗的 8 例鼻腔鼻窦 SH 患者,并进行了系统的文献回顾,分析了文献中描述的 48 例 SH 病例。

结果

在本机构接受治疗的 8 例患者中,肿瘤起源于后鼻腔 4 例,中鼻甲和中鼻道各 2 例。4 例存在炎症性鼻息肉(NPs)共存。组织病理学上,4 例表现为局灶性呼吸型上皮腺瘤样错构瘤(REAH)特征,1 例存在低级别异型增生。综合分析文献发现,所有病例中,46.3%起源于前鼻腔。伴有 NPs 和局灶性 REAH 特征的病例比例分别为 20.5%和 39.1%。此外,存在异型增生特征(5.4%)和复发(2.1%)的病例频率较低。值得注意的是,起源于前鼻腔区域的肿瘤,其异型增生的频率高于起源于后鼻腔区域的肿瘤,但差异无统计学意义(p=0.0996)。

结论

鼻腔鼻窦 SH 患者经手术切除后可获得良好的治疗效果。常观察到局灶性 REAH 特征和伴随的 NPs。相当一部分病例起源于前鼻腔,这些肿瘤可能具有较高的异型增生倾向。

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