Perzin K H, Pushparaj N
Cancer. 1984 Nov 1;54(9):1860-9. doi: 10.1002/1097-0142(19841101)54:9<1860::aid-cncr2820540916>3.0.co;2-9.
Twelve cases of meningiomas involving the nasal cavity and paranasal sinuses are reported. Meningiomas only rarely involve the upper respiratory tract; these 12 cases were found among the 566,000 surgical pathology cases that have been studied in this laboratory. In this series, five meningiomas probably arose in the cranial cavity and secondarily extended into the nasal cavity and paranasal sinuses. Because radiographs demonstrated hyperostosis or bone destruction, three other tumors could have involved the cranial cavity, but this was never proven. In two other cases, the meningiomas appeared to involve only extracranial tissues and thus probably were primary extracranial lesions. (The data available in two other cases were insufficient to assess the possibility of intracranial involvement). These patients clinically had nonspecific signs and symptoms similar to those produced by other types of neoplasms growing in the upper respiratory tract. The tumor involved the sphenoid area in seven cases, the nasal cavity in six, the maxilla in five, the ethmoid sinus in four, and the frontal sinus in one. The diagnosis was first established when biopsy material was examined, although in several cases the presence of meningioma was first suggested on radiographic examination. Treatment depended upon the size and location of the tumor. In some cases, surgical resection appeared to control the lesion. These tumors did not appear to respond well to radiotherapy. The histologic differential diagnosis is discussed.
本文报告了12例累及鼻腔和鼻窦的脑膜瘤。脑膜瘤很少累及上呼吸道;在本实验室研究的566,000例手术病理病例中发现了这12例。在这一系列病例中,5例脑膜瘤可能起源于颅腔,继而延伸至鼻腔和鼻窦。因为X线片显示有骨质增生或骨质破坏,另外3例肿瘤可能累及颅腔,但从未得到证实。在另外2例中,脑膜瘤似乎仅累及颅外组织,因此可能是原发性颅外病变。(另外2例的现有数据不足以评估颅内受累的可能性)。这些患者临床上有与在上呼吸道生长的其他类型肿瘤相似的非特异性体征和症状。肿瘤累及蝶骨区域7例,鼻腔6例,上颌骨5例,筛窦4例,额窦1例。虽然在一些病例中,脑膜瘤的存在首先是在X线检查时被提示,但诊断首先是在检查活检材料时确立的。治疗取决于肿瘤的大小和位置。在一些病例中,手术切除似乎能控制病变。这些肿瘤似乎对放疗反应不佳。文中讨论了组织学鉴别诊断。