复发性泪腺区肿瘤25例临床病理分析

目的：探讨复发性泪腺区肿瘤的临床特征和组织病理学类型。方法：回顾性研究。收集2004-01/2014-02在我科确诊的25例复发性泪腺区肿瘤患者的临床和病理资料,对其临床表现、复发情况、组织病理学分型及预后情况进行分析。结果：所选25例患者中21例为初次复发,1例为3次复发,3例为2次复发。最后一次手术到最近一次复发间隔1mo~28a(中位数1a)。复发后在我院手术时的年龄17.5~70(平均47.9)岁。组织病理检查：多形性腺瘤4例,多形性腺瘤恶变2例,腺样囊性癌10例,上皮-肌上皮癌3例,恶性多形性腺瘤3例,腺癌1例,间叶组织肿瘤1例,黏膜相关淋巴组织淋巴瘤1例。结论：泪腺区复发性肿瘤种类繁多,以腺样囊性癌最多,其次是多形性腺瘤；恶性肿瘤复发率高；多形性腺瘤初次手术完整的切除,对预防术后复发和恶变至关重要。同时早期及长期的随访,对发现肿瘤复发,也非常重要。

Clinical and pathological analysis of 25 cases with recurrent tumor of lacrimal gland

AIM: To analyze the clinical features and histopathological types of recurrent lacrimal gland tumors.

METHODS: Retrospective study was performed to analyze the clinical manifestation, relapse, histopathological classification and prognosis by the clinical and pathological data of 25 relapsed patients who confirmed by pathological examination in our department from Jan.2004 to Feb.2014.

RESULTS: A total of 21 cases were the first time in 25 patients with recurrence, 1 case was 3 times of relapse, 3 cases of recurrence of 2 times. The last surgery last time to recurrence interval ranged from 1 month to 28 years(mean 1 year). The patients aged from 17.5 to 70 years(mean 47.9 years). The pathological examination showed that: 4 cases were Pleomorphic adenoma, including 2 cases of malignant transformation,10 cases were adenoid cystic carcinoma, 3 cases were epithelial-myoepithelial carcinoma, 3 cases were malignant pleomorphic adenoma and 1 case was adenocarcinoma, 1 case was mesenchymal tissue tumor, 1 case was mucosa-associated lymphoid tissue lymphoma.

CONCLUSION: There are many different kinds of recurrent tumor in the lacrimal gland, with adenoid cystic carcinoma most, the second is pleomorphic adenoma. Relapse rates are higher in the malignant tumor. Pleomorphic adenomas first complete resection surgery is very important to the prevention of postoperative recurrence and canceration. Early and longer-term follow-up is also important to find recurrent tumor.