颈动脉鞘血管平滑肌瘤误诊为颈动脉体瘤

平滑肌瘤是起源于平滑肌的良性肿瘤,起源于小血管至大血管的肌肉层的平滑肌瘤即血管平滑肌瘤。头颈部少见,在头颈部可发生于耳、唇、鼻腔、筛窦、腮腺及喉部。病因不明,女性多发。作者报道１例颈动脉鞘的被误诊为颈动脉体瘤的血管平滑肌瘤的病例。患者男,６１岁。右颈部缓慢增长的无痛性肿块６个月,大小为２×３ｃｍ,位于右胸锁乳突肌前缘靠近下颌角处,触诊光滑,较固定,无杂音。ＣＴ扫描发现右颈动脉分支处有一增强物,动脉造影发现右颈外动脉内侧有一中度多血管物质,未见栓塞。诊断为颈动脉体瘤。手术切除肿物。肿物大小为２．５…     

颈动脉体瘤误诊为鼻咽癌颈部淋巴结转移死亡一例

颈动脉体瘤误诊为鼻咽癌颈部淋巴结转移死亡一例李正贤患者女，２７岁。左颈部无痛性肿物９个月，不伴有血涕、耳鸣、听力下降等症状。ＣＴ扫描示鼻咽腔狭窄，左侧壁向鼻咽腔突出，深部有肿块，临床诊断为鼻咽癌。１９９７年１月２４日在本院肿瘤科进行放射治疗，共１１次...     

以声嘶为主要症状的胸主动脉瘤一例

胸主动脉瘤是由于主动脉管壁发生退行性改变而产生,可导致声音嘶哑而首先就诊于耳鼻咽喉科容易造成误诊误治,我科于2011年2月收治1例,介绍如下.患者男,39岁,因发现声音嘶哑5个月入院.患者平素体健,无外伤史,无肝炎、结核及性病史,无高血压、糖尿病史.入院检查血常规、生化及输血前全套均正常,电子喉镜检查示左侧声带固定,内收和外展运动消失(图1).     

鼻腔混合瘤误诊为鼻息肉一例

鼻腔混合瘤是一种很少见的疾病,现将遇到的1例报告如下。 女性,35岁。因右侧鼻塞4年,逐渐加重,伴头痛,溢脓涕,诊断为鼻息肉入院。体检:右侧鼻背隆起,一肿物充满整个右侧鼻腔并突入前庭,呈灰白色,表面光滑,质软,基底不清,可活动。左侧鼻腔除为中隔突向外,余正常,耳,咽部正常。鼻窦瓦氏位X线摄片:右侧上颌窦密度增高,鼻中隔向左侧移位。1986年4月29日,在局麻下拟按鼻息肉摘除。术中发现肿物质脆,出血多,其蒂附于鼻中隔,遂摒除鼻息     

颈静脉球体瘤误诊为腮腺肿瘤一例

颈静脉球体瘤误诊为腮腺肿瘤一例洪育明，许培珊患者，女，３４岁。主诉右耳后肿块、右眼闭不拢，口角歪斜７个月。右耳后肿物缓慢肿大，无红、痛及破溃，伴右侧头痛，右面颊部烧灼麻木感，无吞咽困难及声嘶，无鼻塞及吸入性血痰、耳漏、眩晕及复视。起病以来精神较差，食...     

巨大颈动脉体瘤切除一例

患者男 ,5 0岁 ,于 2 0 0 0年 4月 2 0日因右面颈肿块 2 4年 ,伴呼吸、吞咽困难 1年收入院。 10余年前曾就诊外院行面颈肿物探查术 ,术中发现瘤体巨大、血供丰富而中止手术 ,术后诊断 :海绵状血管瘤。入院查体见右软腭膨隆 ,可触及 6cm× 4cm肿物 ,右面颈部可触及 10cm× 16cm肿物 ,质实 ,皮温高 ,颈部轴位CT示右咽旁富血供占位约 8 6cm× 7 0cm(图1)。数字减影血管造影提示瘤体与颈部大血管关系不密切。因曾有手术探查史及伴吞咽呼吸困难 ,不能平卧 ,未行颈动脉压迫训练。于 2 0 0 0年 5月 10日在全身麻醉下行右颈部肿物切除术。术中先行…     

自发性颈内动脉瘤误诊一例

患者男 ,47岁。因咽异物感 3个月余 ,右侧咽部肿物进行性长大 3周 ,以“右咽旁占位性病变”收入院。 3月前无明显诱因自觉咽部不适、有异物感 ,无发热及局部疼痛。发现右咽侧壁自上垂下一肿物 ,粉红色 ,无痛。自用食盐涂于其表面 2、3次后 ,该物自行消失。入院前 3周 ,上述症状再次出现 ,同时有右侧剧烈头痛。在当地医院行对症处理 ,症状缓解不明显。咽部肿物迅速长大并出现吞咽困难、讲话不清。当地医院曾行局部穿刺及切开粘膜表面“排脓” ,未见脓液和出血。为进一步诊治转来我院。入院检查 :一般情况好 ,生命体征平稳 ,神志清楚。右侧Ｈ…     

长期误诊为鼻窦炎的瘤型麻风病一例

患者男,37岁,因鼻塞3年,面部浮肿、脱毛,伴躯干、四肢起红斑1年余于2011年12月18日入院.患者3年前无明确诱因出现鼻塞,常有涕中带血,曾多次在当地医院耳鼻咽喉科就诊,诊断为“鼻窦炎”,给予对症治疗,症状偶可缓解.     

Internal carotid artery aneurysm presenting as sinus pain

Sinusitis and its associated facial pain are frequently seen by ENT surgeons. However, it is important to have a high index of suspicion in cases with atypical symptoms, particularly those with unexplained, unilateral, severe facial pain, and to consider an internal carotid artery dissection. This important diagnosis accounts for almost 20 per cent of all strokes in the young, and anti-coagulation can help to prevent thrombosis and embolism. Two cases are presented for illustration.     

Intracavernous carotid artery aneurysm presenting as recurrent epistaxis

Massive epistaxis from a leaking intracavernous carotid artery aneurysm is a rare occurrence. Such an unusual case is presented with appropriate imaging and a successful treatment program.     

A case of internal carotid artery aneurysm diagnosed on basis of massive nosebleed

The authors report a rare case of a nontraumatic giant internal carotid aneurysm which ruptured into the nasal cavity, causing massive rhinorrhagia in a 64-year-old Japanese woman. CT images of the head revealed an aneurysm having a diameter of about 5 cm with a neighboring area of erosion of the anterior base of the skull, and a swelling extending to inside the sphenoidal sinuses. Cerebal angiography resulted in a diagnosis of a giant aneurysm of the left internal carotid artery. Coil embolization and other surgical treatments were recommended, but the patient's family refused to consent and requested only conservative therapy. The natural course of the patient was thus followed, and the patient died after repeated episodes of aneurysm rupture and massive nosebleeds. It was concluded that curative therapy should be administered as soon possible upon diagnosis of this disease.     

颈外动脉转位替代颈内动脉手术一例

颅外颈动脉瘤可引起患者血管破裂出血、脑梗塞甚至致残和死亡,所以治疗颅外真性颈内动脉瘤一直面临着挑战.湖南省肿瘤医院头颈外科手术治疗1例颅外颈内动脉瘤,效果良好,现报道如下.     

Pseudo aneurysm of the external carotid artery: report of a case

The authors report a case of left otorrhagia in a 1-year-old male infant in the presence of a mass involving the parotideal and upper cervical regions, which had appeared after an infection of the upper airways. Non-invasive techniques, such as echography and CT scan, provided useful but contradicting information. Surgery allowed us to define the diagnosis of mycotic aneurysm of the external carotid artery. The authors, after pointing out the extreme rarity of such a pathology, discuss the ethiopathogenetic theories, the clinical features, the diagnosis and the surgical and medical treatment of the disease. Concerning surgery ligation of the external carotid artery is the treatment of choice, since distally the blood flow is provided by a conspicuous collateral circle and because a possible postoperative septic dissemination is avoided.