原发于眼外肌肿瘤的临床分析

目的 分析原发于眼外肌肿瘤的临床特征,为其诊断和治疗提供一定的帮助.方法 回顾性分析1990年1月至2006年7月天津医科大学第二医院诊治的9例原发于眼外肌肿瘤患者的临床资料,总结其临床表现、病理类型、影像学检查及临床治疗方法.结果 原发眼外肌肿瘤9例,累及内直肌6例,外直肌2例,下直肌和下斜肌1例;累及肌全长3例、肌腹及前部肌腱2例,肌腹及后部肌腱3例,单纯肌腹1例;静脉性血管瘤3例,纤维血管瘤2例,神经鞘瘤2例,纤维组织细胞瘤1例,副神经节瘤1例;影像学表现受累眼外肌高度肿大,边界清楚,B超、彩色超声多普勒血流成像、CT和MRI检查结果的表现各有特点;手术摘除肿物,部分病例切除眼外肌后行直肌移位术.结论 原发于眼外肌肿瘤以血管性肿瘤多见;临床特点为肌止点充血水肿,眼球突出并向受累肌肉对侧移位;病变内部影像学特性与其病理类型有关;手术切除肿物效果良好.

Clinical analysis of primary extraocular muscles tumors

Objective To analyze the clinical manifestation of primary extraocular muscles tumors and to study the diagnosis and therapy of this disorder.Methods Retrospective analysis of the clinical data of all primary extraocular muscles tumors (the diagnosis was confirmed by operation and pathological examination) in our hospital.Results There were 9 cases of primary extraocular muscle tumors.Six cases involved the internal rectus,2 cases involved the external rectus,1 case involved beth inferior rectus and inferior oblique.Three cases involved the total length of the muscle;2 cases involved the anterior muscle tendon and belly,3 cases involved the posterior muscle tendon and belly,1 case involved the muscle belly only.There were 3 cases of venous hemangioma,2 cases of fibroangioma,2 cases of neurilemoma,1 case of fibrous histiocytoma and 1 case of paraganglioma.Image examination showed significant enlargement of extraocular muscle with clear boundary.B-scan ultrasonography,color Doppler flow image,CT and MRI scan showed different features.Patients were treated by excision of the tumor.Transplantation of the rectus was performed in several cases after the excision of the muscle.Conclusions Vascular tumors are the most common type of primary extraocular muscle tumors.Congestion and swelling can be observed at the insertion of the rectus.The eyeball is proposed and moved to the opposite side of the affected muscle.Changes in the image analysis are related to the pathologic features.A good therapeutic results can be achived by surgical excision of the tumor.