本文選題：鼻腔 + 神經(jīng)內(nèi)分泌癌��； 參考：《浙江大學(xué)》2011年碩士論文

【摘要】：目的：本文結(jié)合2例鼻腔神經(jīng)內(nèi)分泌癌病例,復(fù)習(xí)國(guó)內(nèi)外相關(guān)文獻(xiàn)資料,分析和總結(jié)鼻腔神經(jīng)內(nèi)分泌癌的臨床特征、發(fā)病誘因、病理表現(xiàn)、治療及預(yù)后,以提高對(duì)鼻腔神經(jīng)內(nèi)分癌的認(rèn)識(shí),并為以后的臨床工作提供幫助。 方法：分析浙江大學(xué)附屬第一醫(yī)院耳鼻咽喉科2010年收治的2例鼻腔神經(jīng)內(nèi)分癌病例,查找美國(guó)國(guó)立圖書館PubMed.萬(wàn)方數(shù)據(jù)資源系統(tǒng)、維普期刊在線數(shù)據(jù)庫(kù)的相關(guān)文獻(xiàn),進(jìn)行文獻(xiàn)復(fù)習(xí)。 結(jié)果：病例1為62歲男性患者,臨床表現(xiàn)為右鼻塞、鼻出血伴右側(cè)鼻背部麻木感,查體見右側(cè)鼻腔內(nèi)充滿灰白色新生物,CT示右側(cè)上頜竇、篩竇、蝶竇、額竇及右鼻腔內(nèi)廣泛占位,增強(qiáng)明顯。經(jīng)鼻側(cè)徑路行腫瘤切除術(shù),術(shù)后聯(lián)合放化療,目前隨訪7月未見腫瘤復(fù)發(fā)及轉(zhuǎn)移,病理診斷為小細(xì)胞型神經(jīng)內(nèi)分泌癌。病例2為56歲男性患者,臨床表現(xiàn)為左側(cè)上唇、上頜竇區(qū)麻木伴左側(cè)鼻塞,查體見左側(cè)鼻底、鼻腔外側(cè)壁、鼻咽部及左側(cè)硬腭粘膜下隆起。MRI示左側(cè)鼻腔、上頜竇及左側(cè)鼻咽部異常信號(hào),T1WI呈低信號(hào),T2WI呈高信號(hào),增強(qiáng)顯示病灶明顯不均勻強(qiáng)化�；顧z病理考慮神經(jīng)內(nèi)分泌癌,予放化療治療。已隨訪8個(gè)月未見腫瘤復(fù)發(fā)及轉(zhuǎn)移。 結(jié)論：鼻腔神經(jīng)內(nèi)分泌癌為罕見的鼻腔惡性腫瘤。其發(fā)病可能與輻射相關(guān),臨床表現(xiàn)多樣化。診斷主要依靠組織病理學(xué)表現(xiàn)及免疫組化染色,CT及MRI影像學(xué)檢查有助了解病變范圍及性質(zhì)。鼻腔神經(jīng)內(nèi)分泌癌的具體治療及預(yù)后情況與分型相關(guān)。其中類癌經(jīng)單純手術(shù)治療即可獲得良好預(yù)后。非典型類癌手術(shù)范圍較類癌廣必要時(shí)可聯(lián)合放療或化療,預(yù)后一般。小細(xì)胞神經(jīng)內(nèi)分泌癌惡性程度最高,多選擇放化療聯(lián)合治療,預(yù)后最差。
[Abstract]:Objective: to review the literature of 2 cases of neuroendocrine carcinoma of nasal cavity, and to analyze and summarize the clinical features, pathogenesis, pathological manifestation, treatment and prognosis of neuroendocrine carcinoma of nasal cavity. In order to improve the understanding of nasal nerve cancer, and provide help for clinical work in the future. Methods: two cases of nasal nerve cancer were analyzed in the Department of Otorhinolaryngology, the first affiliated Hospital of Zhejiang University in 2010. Wanfang data Resource system, the related literature of WIP journal online database, literature review. Results: case 1 was a 62-year-old male. The clinical manifestations were right nasal obstruction, epistaxis with right nose and back numbness. The right nasal cavity was filled with grayish white neo-biologic CT scan showing the right maxillary sinus, ethmoid sinus, sphenoid sinus, right maxillary sinus, ethmoid sinus and sphenoid sinus. The frontal sinus and the right nasal cavity occupy a wide range of space, the enhancement is obvious. Tumor resection was performed via nasal approach combined with radiotherapy and chemotherapy. No recurrence or metastasis of the tumor was found during the follow-up period of 7 months and the pathological diagnosis was small cell neuroendocrine carcinoma. Case 2 was a 56-year-old male. The clinical manifestations were left upper lip, numbness of maxillary sinus region with left nasal obstruction, left nasal floor, lateral wall of nasal cavity, submucosal eminence of nasopharynx and left hard palate. MRI showed left nasal cavity. The abnormal signal intensity of maxillary sinus and left nasopharynx showed low signal intensity on T _ 1WI and high signal intensity on T _ 2WI. Neuroendocrine carcinoma was taken into account in biopsy and pathology and was treated with radiotherapy and chemotherapy. No tumor recurrence or metastasis was found after 8 months follow-up. Conclusion: neuroendocrine carcinoma of nasal cavity is a rare malignant tumor of nasal cavity. The disease may be related to radiation and its clinical manifestations are diverse. The diagnosis mainly depends on histopathological findings and immunohistochemical staining CT and MRI imaging to help understand the extent and nature of the lesions. The specific treatment and prognosis of neuroendocrine carcinoma of nasal cavity are related to classification. Among them, carcinoid can obtain good prognosis by simple surgical treatment. Atypical carcinoid surgery is more extensive than carcinoid, if necessary combined with radiotherapy or chemotherapy, the prognosis is mediocre. The malignant degree of small cell neuroendocrine carcinoma is the highest and the prognosis is the worst.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2011
【分類號(hào)】：R739.63

【共引文獻(xiàn)】

相關(guān)博士學(xué)位論文 前2條

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相關(guān)碩士學(xué)位論文 前2條

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2 林于峰;侵襲性垂體腺瘤綜合治療及Ki-67抗原表達(dá)與垂體腺瘤侵襲性的關(guān)系[D];福建醫(yī)科大學(xué);2007年

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本文編號(hào)：2080360