7例颞骨骨巨细胞瘤的临床分析

目的：探讨颞骨骨巨细胞瘤(giant cell tumor of temporal bone，GCTTB)的病因、诊断、鉴别诊断及合理的治疗方法。方法：治疗方法以手术为主，7例中肿瘤根治性切除5例，临界切除2例(术后1年复发，病理Ⅱ级)。结合经病理学证实的GCTTB的临床资料，复习有关文献并对7例GCTB的临床、组织学和影像学等资料进行分析。结果：7例GcTTB中，右侧颞骨5例，左侧2例。病理Ⅰ级1例。Ⅰ～Ⅱ级2例，Ⅱ级4例。临床表现依肿瘤所在具体部位而有所不同：耳呜6例，耳鸣伴听力损失5例，其中有2例患侧耳全聋。眩晕2例．面瘫伴听力受损1例。3例术后行放射治疗，其中2例疗效良好．1例复发(为临界切除患者)。结论：明确诊断GCTTB必须综合临床、影像和病理三方面资料，手术彻底切除是最有效的治疗方法，术后辅以放疗可能有一定的作用。

Giant cell tumor of temporal bone:a report of 7 cases

OBJECTIVE: To investigate the clinical course, auxiliary examinations, histologic feature, diagnosis, differential diagnosis and treatment of giant cell tumor of temporal bone (GCTTB). METHOD: Seven cases of GCTTB, which arose in temporal bone, were collected from 1990 to 2002 and analyzed clinicopathologically. RESULT: Seven cases with the GCTTB are reported, including 3 females, 4 males. The age of 7 patients between 9 to 53 years. Five tumors located in right side temporal bone, two in left side temporal bone. One patients was pathological I grade, two I-II grade, and four II grade. The clinical course were different according to the position of the tumors: including tinnitus 6 cases, tinnitus with hear loss 5 cases(2 cases with anakus of trouble side ear), vertigo 1 case, facial paralysis with hear loss 1 case. Radical resections were performed in five cases and subtotal resections in two (recurrence, one year after operation, II grade pathologically). Postoperative Radiotherapy was conducted in three cases. CONCLUSION: Diagnosis of GCTTB is based on typical histologic features and imagine as well as clinical information. Complete surgical resection is believed to be the most suitable treatment for GCTTB and postoperative radiotherapy may be effective.