儿童眼睑及眉弓钙化上皮瘤28例手术治疗分析

目的探讨儿童眼睑及眉弓钙化上皮瘤的临床、病理特点和手术方法。方法回顾性分析经手术治疗的儿童眼睑及眉弓钙化上皮瘤28例(28眼)。结果男12例,女16例。均为单发。发现肿块的平均年龄2岁9个月(年龄范围5月～8岁);就诊平均年龄3岁8个月(年龄范围7月～12岁)。均因发现眼睑及眉弓缓慢生长的皮下硬结就诊。瘤体位于上跟睑13例、下眼睑1例、眉弓14例。瘤体直径4～15mm,平均直径7mm。瘤细胞由影细胞与嗜碱性细胞组成。临床误诊率21,42%。术后无复发。结论钙化上皮瘤临床特征为坚硬的缓慢生长的皮下小结,病理组织学特征有嗜碱性细胞与影细胞。最佳治疗是手术,分别采用不同的手术方法,手术效果良好。

A study on 28 cases'''' operation to treat pilomatrixoma of the eyelids and eyebrows in children

Objective To review the clinical and histopatho- logic features and discuss the guidelines for surgical management of pilomatrixomas involving the eyelids and eyebrows in children. Methods 28 patients with pilomatrixomas who underwent surgical excision was reviewed. Results Of 28 patients, there were 12 males and 16 females. All patients had solitary lesions. Mean age when pilomatrixomas was discovered was 2. 9 years (range from 5months to 8 years). Mean age at the time of diagnosis was 3.8 years (range from 7months to 12 years). The presenting symptom was a hard, slowly growing subcutaneous mass in all 28 patients. The tumor occurred on the upper lid in 13 cases, in the brow in 14 cases, on the lower eyelid in 1 case. The size of the tumors ranged from 4 to 15 mm in diameter. Mean diameter was 7 mm. 19 patients had hyaeinthdiscoloration of the overlying skin, 6 patients had pink discoloration of the overlying skin, and 3 patients had normal skin on the tumor surface, 2 patient had ulceration on the tumor sur- face. The mass was adherent to the skin but not fixed to the under lying tissue. This tumor was composed of two cell types:the shadow cells and basophilic cells. Clinical misdiagnosis rate was 21.42% (6/28). It was commonly misdiagnosed preoperatively as dermoid cyst or angioma. Spontaneous regression was never observed. No recurrence was observed after surgery. No postoperative complica- tion was present in all patients. Conclusions The clinical feature is a hard,slowly-growing subcutaneous nodule. The histopatholog- ic features show two characteristic epithelial cells, the basophilic and shadow cell. Complete surgical excision is the treatment of choice. The prognosis after removal of the tumors is good.