Schick B, Kind M, Schwarzkopf G, Weber R, Draf W
Klinik für HNO-Krankheiten, Kopf-, Hals- und Plastische Gesichtschirurgie, Kommunikationsstörungen, Städtisches Klinikum Fulda.
HNO. 1997 Dec;45(12):1022-8. doi: 10.1007/s001060050188.
Angiofibromas are usually characterized by their occurrences in adolescent males with a typical localization and involvement of the posterior nasal cavity and nasopharynx. Even the suspicion of an extranasopharyngeal angiofibroma or an angiofibroma in young children must be viewed in general with skepticism, although reports of angiofibromas with atypical localizations and manifestations in young children have appeared in the literature. Three cases of this fibro-vascular neoplasm with manifestations in the first decade of life and atypical localizations are presented: (1) an angiofibroma medial to the left lacrimal sac in a 15-month old boy, (2) a right paranasal localization in a 9-year-old boy and (3) an angiofibroma limited to the right sphenoid sinus in a 6-year old boy. In all three cases the neoplasm was resected via an endonasal, micro-endoscopic approach that avoided an external incision. According to the literature and based on our own experiences with typical histological findings in all three cases, the clinician has to be aware that the rare angiofibroma can occur in preadolescent children with atypical localizations. The endonasal surgical approach is without any doubt the least traumatic one and in selected cases allows resection of a circumscribed tumor considering functional and aesthetic aspects.
血管纤维瘤通常表现为好发于青春期男性，典型部位在后鼻腔和鼻咽部。即便怀疑是鼻咽外血管纤维瘤或幼儿血管纤维瘤，总体上也需谨慎看待，尽管文献中有幼儿血管纤维瘤出现非典型部位和表现的报道。本文报告了3例这种纤维血管性肿瘤，其在生命的第一个十年出现且部位不典型：（1）一名15个月大男孩左泪囊内侧的血管纤维瘤；（2）一名9岁男孩右侧鼻旁部位的血管纤维瘤；（3）一名6岁男孩局限于右侧蝶窦的血管纤维瘤。在所有3例中，肿瘤均通过鼻内微内镜手术切除，避免了外部切口。根据文献并基于我们在所有3例中典型组织学发现的经验，临床医生必须意识到，罕见的血管纤维瘤可发生于青春期前儿童且部位不典型。鼻内手术方法无疑是创伤最小的，在某些病例中，从功能和美观角度考虑，可切除边界清晰的肿瘤。
