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目的:探讨头颈部低级别肌纤维母细胞肉瘤的临床特点和CT、MRI表现及诊治方法。方法:回顾性分析6例头颈部低级别肌纤维母细胞肉瘤患者的临床资料和病理特征。术前常规行CT、MRI检查,4例原发上颌窦患者中,3例行上颌骨切除术+局部植皮,1例行术前放疗60Gy未控后再行上颌骨扩大切除术。2例原发喉部患者均行环状软骨上部分喉切除+气管切开。结果:6例患者均行手术治疗,其中1例行术前放疗且剂量大于60Gy。随访6个月~5年,未见复发,未出现其他并发症。结论:头颈部低级别肌纤维母细胞肉瘤是光镜下可辨认的低度恶性肉瘤,术中冷冻切片诊断困难,确诊需术后病理及免疫组织化学结果。治疗以手术扩大切除为主。
Objective: To investigate the clinical features, CT, MRI findings and diagnosis and treatment of low grade myofibroblastic sarcoma in the head and neck. Methods: The clinical data and pathological features of 6 cases of low grade myofibroblastic sarcoma in head and neck were retrospectively analyzed. Preoperative routine CT, MRI examination, 4 cases of primary maxillary sinus patients, 3 cases of maxillary resection + local skin grafting, 1 case of preoperative radiotherapy 60Gy uncontrolled before the maxillary enlargement resection. Two cases of primary laryngeal patients underwent partial cystectomy plus tracheotomy. Results: Six patients underwent surgery. One patient underwent preoperative radiotherapy and the dose was greater than 60 Gy. Follow-up 6 months to 5 years, no recurrence, no other complications. Conclusion: Low-grade myofibroblastic sarcoma in the head and neck is a low-grade malignant sarcoma that can be discerned by light microscopy. It is difficult to diagnose the frozen section during operation. The postoperative pathology and immunohistochemistry results should be confirmed. Surgical treatment to expand the main excision.