以颅底病变为主的鼻咽癌误诊分析

目的分析以颅底病变为主的鼻咽癌患者误诊的原因。方法回顾性分析1992年1月至2009年12月诊治的12例以颅底病变为主的鼻咽癌误诊患者的临床资料,并对误诊疾病及误诊原因进行分析。结果 12例以颅底病变为主的鼻咽癌误诊患者中,有7例（58.3%）误诊为颅底脊索瘤,3例（25.0%）误诊为蝶窦恶性肿瘤,1例（8.3%）误诊为垂体瘤,1例（8.3%）误诊为脑膜瘤。结论对上行型、黏膜下型鼻咽癌特征认识不足、影像学检查部位或检查方法不准确是鼻咽癌误诊主要原因。提高对以颅底病变为主鼻咽癌的认识,重视鼻咽部和颅底的影像学检查,以及鼻咽部多次活检可以降低鼻咽癌的误诊。

Clinical Analysis of Misdiagnosis on Nasopharyngeal Carcinoma with Primary Lesions in Skull-base

Objective To explore the cause for misdiagnose of nasopharyngeal carcinoma（NPC） with primary lesions in skull-base.Methods The clinical features of 12 NPC patients with primary lesions in skull-base were retrospectively analyzed.Results Totally 12 NPC patients with primary lesions in skull-base were misdiagnosed as intracranial disease,such as chordomas of the base of the skull（58.3%）,malignant tumors of the cavernoussinuses（25.0%）,pituitary adenomas（8.3%）,meningiomas（8.3%）.Conclusion Lack of knowledge about NPC and wrong CT scan sites or ways are the main reasons for misdiagnosis.It is important to emphasize the role of NPC with primary lesions in skull-base and the value of imaging of cranial base in the diagnosis.Repeated biopsy of nasopharynx can reduce the misdiagnosis of NPC.