Clinical analysis of five cases of primary sphenoid sinus tumor / 中国医师进修杂志

ABSTRACT

Objective:To study the clinical features, diagnosis and treatment of primary sphenoid sinus tumors and to improve the understanding of clinicians.Methods:The clinical data of 5 cases of primary sphenoid sinus tumors diagnosed by pathology from August 2014 to June 2017 in Affiliated Shengjing Hospital of China Medical University were collected and reviewed. The clinical characteristics, diagnosis and treatment were analyzed.Results:Of the 5 patients, 1 patient was first diagnosed in neurology with headache, 2 patients were first diagnosed in ophthalmology with periorbital pain, and 2 patients were diagnosed with nasal symptoms such as decreased olfactory, nasal congestion, blood stasis, and pharyngeal foreign body sensation. In the otolaryngology department, all patients had no history of head and neck surgery before surgery. All patients underwent sinus CT and MRI. They were suspected of malignant ECT examination. There were no distant metastatic lesions and surgical contraindications. General anesthesia and endoscopic sphenoid sinus surgery was used. And assisted image navigation systems were used in 3 patients. Postoperative pathological returns showed chordoma in 1 case, adenoid cystic carcinoma in 1 case, plasmacytoma in 1 case, poorly differentiated carcinoma in 1 case, and focal malignant transformation of inverted papilloma in 1 case. Patients with chordoma, adenoid cystic carcinoma, poorly differentiated carcinoma and inverted papilloma received foci surgery and were transferred to our hospital for oncology and chemotherapy. Patients with plasmacytoma only had surgery, and received no further treatment for personal reasons. Follow-up lasted 16-50 months and ended on October 1, 2018. Patients with poorly differentiated cancer were followed up for 12 months and died after liver metastases, and the other 4 patients lived well. Our department continued to follow up.Conclusions:The clinical manifestations of primary sphenoid sinus tumors are non-specific. Many of them are in advanced stage. Imaging examination plays an important role in the diagnosis of diseases and the development of surgical methods. Surgery is the main method for the treatment of this disease. Postoperative adjuvant chemotherapy and radiotherapy is of great significance to improve the survival rate of patients.