原发性鼻腔-鼻窦砂粒体型脑膜瘤1例报道并文献复习

Primary psamyoma meningioma in nasal cavity and paranasal sinus: a case report and literature review

摘要:

目的 通过报道1例原发于鼻腔-鼻窦砂粒体型脑膜瘤患者的临床资料及相关文献复习，以提高临床医师对该病的认识及诊疗水平。方法 患者，女，50岁，因"渐进性右侧鼻塞1年余"入院。术前影像学检查提示右侧鼻腔及筛窦内不规则占位性病变，遂在全麻鼻内镜下行右侧鼻腔筛窦肿物切除术。结果 肿物完全切除，术后病理及免疫组化确诊为砂粒体型脑膜瘤（WHO I级）。患者鼻塞及头痛症状消失，术后2个月复诊见鼻腔术区黏膜上皮化完成，鼻腔无粘连，暂未见肿物复发。结论 原发于鼻腔-鼻窦的异位砂粒体型脑膜瘤少见，缺乏特异性临床表现，容易误诊。诊断主要依靠病理检查，治疗上应争取完全切除肿物及周边受侵犯组织，以达到根治，防止复发。

Abstract:

Objective To report the clinical data of a patient with a primary psamyoma meningioma in nasal cavity-paranasal sinus and review the related literature,in order to improve the clinical diagnosis and treatment level of the disease.Methods The patient, a 50-year-old female, was admitted to the hospital for "progressive right-sided nasal obstruction for more than one year". Preoperative imaging examination revealed irregular space-occupying lesions in the right nasal cavity and ethmoid sinus, and the mass was removed under general anesthesia and endoscopy.Results The tumor was completely resected,and the mass was diagnosed for Psamyoma Meningioma (WHO grade I) by postoperative pathology and immunohistochemistry.The patient’s nasal obstruction and headache symptoms disappeared, and the epithelialization of the mucosa in the nasal cavity was completed at the follow-up 2 months after the operation. There was no adhesion in the nasal cavity, and no tumor recurrence was found.Conclusion Ectopic Psamyoma Meningioma originating in the nasal cavity and paranasal sinuses is rare. The disease lacks specific clinical manifestations,which is easily misdiagnosed. Diagnosis mainly depends on pathological examination, and treatment should strive for a complete resection of the tumor and the surrounding invaded tissue, in order to achieve a radical cure and prevent recurrence.