小肠平滑肌肉瘤8例误诊分析

目的探讨小肠平滑肌肉瘤的临床表现、术前误诊的原因。方法对8例小肠平滑肌肉瘤病例的临床表现、影像学检查、术前诊断、术中所见及手术方法进行总结分析。结果术前8例均被误诊,误诊为肠套叠4例,空肠血管瘤1例,卵巢肿瘤2例,盆腔肿瘤1例;8例均经术后病理检查证实为小肠平滑肌肉瘤。1例行胰十二指肠切除术,4例行根治性小肠平滑肌肉瘤切除术,其余3例因侵犯广泛而无法切除。4例术后2年内死亡,其余4例目前仍存活,无复发。结论小肠平滑肌肉瘤缺乏特征性的临床表现而常常被误诊,影像学检查有助于术前诊断,手术切除是目前唯一有效的根治性治疗方法。

Misdiagnosis analysis of 8 cases with small intestinal leiomyosarcoma

Objective To investigate the clinical manifestations,the cause of preoperative misdiagnosis of small intestinal leiomyosarcoma.Methods Clinical findings,imaging examinations,preoperative diagnosis,intraoperative findings and operative styles of 8 cases with small intestinal leiomyosarcoma were analyzed retrospectively.Results All of the 8 cases were misdiagnosed preoperatively.4 cases were misdiagnosed as intussusception,1 case as jejunal haemangioma,2 cases as ovarian tumor and 1 case as pelvic tumor.Pathological diagnoses of those 8 cases were confirmed postoperatively as small intestinal leiomyosarcoma.1 patient underwent pancreatoduodenectomy,4 patients underwent radical resection of small intestinal leiomyosarcoma.The tumors of the other 3 patient were not been removed because of extensive invasion.4 cases died in the duration of two years after operation.The other 4 cases are still alive without evidence of recurrence.Conclusion Lack in characteristic of clinical manifestations of small intestinal leiomyosarcoma usually causes a preoperative misdiagnosis.Imaging examinations are significant for its preoperative diagnosis.Resection is the unique effective means for the radical treatment of small intestinal leiomyosarcoma.