头颈部恶性纤维组织细胞瘤的诊治

目的 探讨头颈部恶性纤维组织细胞瘤的临床特点、诊断和治疗。方法 总结1980年1月～2002年12月在我院手术治疗的6例头颈部恶性纤维组织细胞瘤，分析其临床特点、诊断和治疗过程。结果 6例病人的共同临床表现均为局部肿块合并或不合并肿块引起的功能障碍。病理表现为轮辐状排列的纤维母细胞，混杂有其他多种细胞成分，细胞有明显的异型性。6例病人均接受了局部扩大的手术切除，术后3例病人复发，其中2例死于颅内转移。1例有可疑胸壁转移，行局部放疗和手术切除。1例无瘤存活。1例术后失访。结论 头颈部恶性纤维组织细胞瘤在临床上少见，易于与其他肿瘤混淆；其临床特点是容易复发，容易转移；预后差。因此，对病情反复的可疑头颈部肿瘤病人应警惕恶性纤维组织细胞瘤的可能。对确诊为头颈部恶性纤维组织细胞瘤的病人应行扩大的手术切除和放疗，术后严密随访。

Diagnosis and treatment of malignant fibrous histiocytoma of head and neck

ObjectiveTo explore the clinical charac teristic, diagnosis and treatment of malignant fibrous histiocytoma (MFH) of head and neck. MethodsSix cases of MFH of head and neck from 1980 to 2002 were studied. Their clinical manifestation, diagnosis, treatment and prognosis were analysed. ResultsThe common clinical symptoms of these cases were local masses with/without related dysfunction caused by the masses. The pathology of the MFH of head and neck was storiform fibroblasts mixed with histiocyte, giant cell and other cells. All cells displayed varied anaplasia. All patients received wide local excision. After operation, 3 patients had tumor recurrence, among which 2 patients died from cerebral metastasis of MFH. One patient had suspicious metastasis of pleural wall and received radiotherapy followed by local excision. Only one patient survived without tumor. The last one could not be contacted. ConclusionMFH of head and neck rarely is found in clinical, and so is apt to be mistaken for for other tumors. MFH of head and neck has high frequency of recurrence and metastasis. The prognosis of MFH of head and neck is poor. So diagnosis of a patient with tumor of head and neck, especially recurred tumor, should include MFH. The best treatment of MFH of head and neck is wide resection of tumor and radiotherapy ,as well as careful follow-up.