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眼眶胚胎性横纹肌肉瘤:基于病例的最新研究进展。

Orbital embryonal rhabdomyosarcoma: a case-based update.

机构信息

Department of Neuroscience, Section of Neurosurgery, Università Cattolica del Sacro Cuore, Rome, Italy.

Pediatric Neurosurgery, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.

出版信息

Childs Nerv Syst. 2024 Dec;40(12):3907-3914. doi: 10.1007/s00381-024-06583-6. Epub 2024 Sep 28.

Abstract

BACKGROUND

Rhabdomyosarcoma (RMS) is the most prevalent soft tissue sarcoma in children, with approximately 30% of head and neck RMS occurring in the orbit. The management of orbital RMS is complex, requiring a multidisciplinary approach and careful surgical planning. The objective of the present paper is to provide the neurosurgeon with an update on this challenging tumor.

CASE DESCRIPTION

A 12-year-old boy was admitted to our department after the onset of diplopia in his right eye, associated with quickly worsening ipsilateral eyelid edema and mild proptosis. MRI revealed an anterior superomedial, extraconal, and intraorbital expansive lesion. Complete tumor removal was performed through a trans-orbital approach. Histological diagnosis of embryonal RMS was done. The patient underwent radio-chemotherapy in accordance with the EpSSG RMS2005 subgroup C protocol. The patient is alive and disease-free.

DISCUSSION AND CONCLUSION

The intricacies of treating orbital tumors necessitate meticulous planning to safeguard vital structures while guaranteeing comprehensive oncological treatment. A multidisciplinary approach with a specific protocol depending on the location and characteristics of the tumor is required. The available treatment options include surgical intervention or combination therapies, such as chemotherapy and radiotherapy. The successful management of these diseases depends on the careful coordination and application of the available techniques.

摘要

背景

横纹肌肉瘤(RMS)是儿童中最常见的软组织肉瘤,约有 30%的头颈部 RMS 发生在眼眶。眼眶 RMS 的治疗较为复杂,需要多学科的方法和仔细的手术规划。本文的目的是为神经外科医生提供有关这种具有挑战性的肿瘤的最新信息。

病例描述

一名 12 岁男孩因右眼复视、同侧眼睑迅速肿胀和轻度眼球突出而就诊于我科。MRI 显示前内侧、眶外和眶内扩张性病变。通过经眶入路进行了完全肿瘤切除。组织学诊断为胚胎性 RMS。患者按照 EpSSG RMS2005 亚组 C 方案接受了放化疗。患者目前存活且无疾病。

讨论和结论

治疗眼眶肿瘤的复杂性需要进行细致的规划,以在保护重要结构的同时确保全面的肿瘤治疗。需要采用根据肿瘤位置和特征制定的多学科方法和特定方案。治疗选择包括手术干预或联合治疗,如化疗和放疗。成功治疗这些疾病取决于对现有技术的仔细协调和应用。

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