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侵犯中耳和颅底的巨细胞瘤的罕见表现及切除术:一例报告

Rare presentation and resection of giant cell tumor invading the middle ear and skull base: A case report.

作者信息

Cohen Joshua M, Jung Geena, Reisert Hailey, Lu Yi-Hsueh, Liriano Genesis, Schiff Bradley A, Garfein Evan S, Kobets Andrew J

机构信息

Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.

Department of Plastic and Reconstructive Surgery, Montefiore Medical Center, Bronx, NY, USA.

出版信息

JPRAS Open. 2025 Feb 1;43:544-550. doi: 10.1016/j.jpra.2025.01.020. eCollection 2025 Mar.

Abstract

Giant cell tumors (GCTs) are common benign bone tumors found in young adults, frequently occurring in the long bones but rarely in the skull. Although considered benign, GCTs have the potential to be aggressive, destroying surrounding tissue. Here, we present the unusual case of a patient with a GCT of the middle ear and skull base. A 19-year-old male with an extensive giant cell tumor underwent surgical resection by a multidisciplinary team consisting of otolaryngology, neurosurgery, and plastic and reconstructive surgery. The mass was grossly resected, and a cervicofacial flap allowed for reconstruction with optimal cosmesis, a procedure not described for GCTs. This approach allowed for excellent wound healing without tumor recurrence. Gross total resection remains the most effective treatment for GCTs, minimizing radiation exposure and recurrence risk. However, an optimal surgical approach for skull GCTs has yet to be described. Skull-base GCTs present a challenge due to their complex anatomy and neurovascular elements. Further, the high rates of local recurrence make gross resection the goal of treatment, though this is difficult to achieve. The present case was successfully managed by extensive multidisciplinary surgical resection, highlighting the necessity of collaborative effects to achieve gross total resection and positive aesthetic outcomes.

摘要

骨巨细胞瘤(GCTs)是常见的良性骨肿瘤,多见于年轻人,常发生于长骨,但很少见于颅骨。尽管被认为是良性的,但骨巨细胞瘤有可能具有侵袭性,会破坏周围组织。在此,我们报告一例中耳和颅底骨巨细胞瘤患者的罕见病例。一名患有广泛骨巨细胞瘤的19岁男性接受了由耳鼻喉科、神经外科以及整形和重建外科组成的多学科团队进行的手术切除。肿瘤被大体切除,采用颈面部皮瓣进行重建,达到了最佳的美容效果,这一手术方法此前未见于骨巨细胞瘤的报道。该方法实现了良好的伤口愈合且无肿瘤复发。完整切除仍然是骨巨细胞瘤最有效的治疗方法,可将辐射暴露和复发风险降至最低。然而,对于颅骨骨巨细胞瘤的最佳手术方法尚未见报道。颅底骨巨细胞瘤因其复杂的解剖结构和神经血管结构而具有挑战性。此外,尽管难以实现,但局部复发率高使得完整切除成为治疗目标。本病例通过广泛的多学科手术切除成功得到处理,突出了协同效应对于实现完整切除和良好美学效果的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b075/11889566/663c1fa7ea15/gr1.jpg

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