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内镜切除下咽部带蒂高分化脂肪肉瘤1例并文献复习

Successful resection of well-differentiated, pedunculated liposarcoma of the hypopharynx by endoscopic dissection: a case report and literature review

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【作者】 何龙杨雅琳陈彦晖郭永梅丁文双陈墅圳高雄辉谢景华

【Author】 HE Long;YANG Yalin;CHEN Yanhui;GUO Yongmei;DING Wenshuang;CHEN Shuzhen;GAO Xionghui;XIE Jinghua;Department of Otorhinolaryngology Head and Neck Surgery, Guangzhou First People’s Hospital, The Second Affiliated Hospital of South China University of Technology;Department of Radiology, Guangzhou First People’s Hospital, The Second Affiliated Hospital of South China University of Technology;Department of Pathology, Guangzhou First People’s Hospital, The Second Affiliated Hospital of South China University of Technology;Department of Gastroenterology, Guangzhou First People’s Hospital, The Second Affiliated Hospital of South China University of Technology;

【机构】 广州市第一人民医院耳鼻咽喉头颈外科华南理工大学附属第二医院广州市第一人民医院影像科华南理工大学附属第二医院影像科广州市第一人民医院病理科华南理工大学附属第二医院病理科广州市第一人民医院消化内科华南理工大学附属第二医院消化内科

【摘要】 目的探讨下咽部脂肪肉瘤的临床特点、诊断、治疗及预后。方法文献复习咽喉部高分化脂肪肉瘤并报告1例65岁主诉恶心时口腔内阵发性肿物外露20年的下咽部带蒂高分化脂肪肉瘤男性患者,行硬性食管镜加支撑喉镜联合鼻内镜检查,发现肿瘤蒂部在左侧梨状窝内侧壁,借助超声刀在肿瘤蒂部完成微创切除。结果内镜微创手术完整切除肿瘤,随访12个月,患者吞咽和呼吸顺利,无复发表现。结论下咽脂肪肉瘤为一种临床罕见低度恶性肿瘤,术前诊断困难,可考虑行内镜微创手术切除为主的治疗并密切随访。提高临床医师对该病的认识对治疗该病具有重要意义。

【Abstract】 Objective To investigate the clinical character, diagnosis and treatment for hypopharyngeal liposarcoma. Methods To review the literature of well-differentiated liposarcoma at the hypopharynx region. A 65 years-old male case with an episode of exteriorization of a solid mass from the mouth during an episode of vomiting for 20 years was reported. Esophagoscopy plus self-retaining laryngoscopy with the aid of nasal endoscopy was performed. The pedicle was found in the inner wall of the left pyriform sinus and the tumor was resected by Harmonic ACE scalpel in a mini-invasive way. Results The tumor was totally resected in an en-bloc style with the help of nasal endoscope. There was no relapse after 12 months of monitoring and the function for swallow and speech is perfect. Conclusion Hypopharyngeal liposarcoma is a rare intermediate malignant tumor, as it is hard to be diagnosed before the surgery. Endoscopic surgery should be a practicable choice with the instant follow-up.

【关键词】 咽肿瘤脂肪肉瘤内镜
【Key words】 Pharyngeal neoplasmLiposarcomaEndoscopy
  • 【文献出处】 广州医药 ,Guangzhou Medical Journal , 编辑部邮箱 ,2019年06期
  • 【分类号】R739.63
  • 【下载频次】68
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