山东大学耳鼻喉眼学报 ›› 2025, Vol. 39 ›› Issue (6): 133-137.doi: 10.6040/j.issn.1673-3770.0.2024.146

• 论著 • 上一篇    

喉纤维肉瘤1例并相关文献复习

刘玉柱1,陈尧1,苑铁君1,李春森2,李波3   

  1. 1.潍坊市人民医院 耳鼻咽喉科, 山东 潍坊 261044;
    2.潍坊市人民医院 病理科, 山东 潍坊 261044;
    3.潍坊市益都中心医院中西医结合康复科, 山东 潍坊 262500
  • 发布日期:2025-11-19
  • 通讯作者: 李波. E-mail:lidyx12@163.com

Larynx fibrosarcoma: a case report and literature review

LIU Yuzhu1, CHEN Yao1, YUAN Tiejun1, LI Chunsen2, LI Bo3   

  1. 1. Department of Otolaryngology, Weifang People's Hospital, Weifang 261044, Shandong, China 2. Department of Pathology, Weifang People's Hospital, Weifang 261044, Shandong, China 3. Department of Integrative Traditional and Western Medicine Rehabilitation, Weifang Yidu Central Hospital, Weifang 262500, Shandong, China
  • Published:2025-11-19

PDF (PC)

9

摘要： 目的 探讨喉纤维肉瘤的临床表现、病理特点、治疗手段及预后。 方法 回顾1例喉纤维肉瘤患者的临床资料并复习相关文献进行总结。 结果 喉纤维肉瘤需与声带(或室带)息肉相鉴别、其确诊主要依靠病理学检查,治疗以手术+放疗为主。 结论 喉纤维肉瘤标准治疗方案仍未建立,手术后辅以放疗有助于提高患者预后,对于早期T1或T2期喉纤维肉瘤,在保证切缘阴性、保留部分喉功能的前提下不宜盲目扩大切除范围,不推荐常规行颈淋巴清扫术,对影像学检查可疑有颈部淋巴结转移者,可清扫同侧Ⅱ-Ⅳ区淋巴结并送术中冰冻,视情况保留对侧颈部淋巴结。

关键词: 喉肉瘤, 纤维肉瘤, 手术治疗, 预后

Abstract: Objective To review the clinical manifestations, pathological features, treatment and prognosis of laryngeal fibrosarcoma. Methods The clinical data of a case of laryngeal fibrosarcoma were reviewed and the relevant literature was reviewed. Results Laryngeal fibrosarcoma should be distinguished from vocal cord(or ventricular)polyps and its diagnosis is mainly based on pathological examination. Treatment consists mainly of surgery + radiotherapy. Conclusion The standard of care for laryngeal fibrosarcoma is still unclear, and the boundaries of safe surgical resection margins need to be further explored. Radiotherapy helps to improve the prognosis of patients. For early T1 or T2 laryngeal fibrosarcoma, it is not advisable to blindly extend the resection area under the premise of ensuring a negative resection margin and preserving some laryngeal function. Routine dissection of cervical lymph nodes is not recommended. In patients with suspected cervical lymph node metastasis on imaging, the ipsilateral II-IV lymph nodes may be dissected and sent for intraoperative freezing, and the contralateral cervical lymph nodes may be reserved as appropriate.

Key words: Laryngeal fibrosarcoma, Surgical treatment, Prognosis

中图分类号: 

  • R767
[1] 秦玲, 李道明. 腺泡状横纹肌肉瘤41例临床病理特征及预后分析[J]. 临床与实验病理学杂志, 2023, 39(7): 822-828. doi:10.13315/j.cnki.cjcep.2023.07.012 QIN Ling, LI Daoming. Alveolar rhabdomyosarcoma: clinicopathologic characteristics and prognostic analysis of 41 cases[J]. Chinese Journal of Clinical and Experimental Pathology, 2023, 39(7): 822-828. doi:10.13315/j.cnki.cjcep.2023.07.012
[2] Skapek SX, Ferrari A, Gupta AA, et al. Rhabdomyosarcoma[J]. Nat Rev Dis Primers, 2019, 5:1. doi:10.1038/s41572-018-0051-2
[3] Lin HW, Bhattacharyya N. Staging and survival analysis for nonsquamous cell carcinomas of the larynx[J]. Laryngoscope, 2008, 118(6): 1003-1013. doi:10.1097/MLG.0b013e3181671b3d
[4] Rotsides JM, Patel E, Oliver JR, et al. Non-squamous cell malignancies of the larynx[J]. Laryngoscope, 2022, 132(9): 1771-1777. doi:10.1002/lary.30007
[5] Galy-Bernadoy C, Garrel R. Head and neck soft-tissue sarcoma in adults[J]. Eur Ann Otorhinolaryngol Head Neck Dis, 2016, 133(1): 37-42. doi:10.1016/j.anorl.2015.09.003
[6] Han S, Yin X, Xu W, et al. The management of head and neck sarcoma[J]. J Craniofac Surg, 2020, 31(2): e189-e192. doi:10.1097/SCS.0000000000006162
[7] Hu J, Lu D, Ren J, et al. Adult laryngeal Embryonal Rhabdomyosarcoma: a case report and literature review[J].BMC Surg, 2020, 20(1): 173. doi:10.1186/s12893-020-00831-7
[8] Fletcher CDM. The evolving classification of soft tissue tumours: an update based on the new WHO classification[J]. Histopathology, 2006, 48(1): 3-12. doi:10.1111/j.1365-2559.2005.02284.x
[9] Harrison L, McCulloch T, Beasley N. Soft tissue head and neck sarcoma: experience of a tertiary referral centre over a 15-year period[J]. J Laryngol Otol, 2019, 133(12): 1053-1058. doi:10.1017/S0022215119002299
[10] González-González R, Bologna-Molina R, Molina-Frechero N, et al. Prognostic factors and treatment strategies for adult head and neck soft tissue sarcoma[J]. Int J Oral Maxillofac Surg, 2012, 41(5): 569-575. doi:10.1016/j.ijom.2012.02.002
[11] Vautravers C, Dewas S, Truc G, et al. Sarcomes en territoire irradié: actualités [J]. Cancer Radiother, 2010, 14(1): 74-80. doi:10.1016/j.canrad.2009.09.003
[12] Thiagarajan A, Iyer NG. Radiation-induced sarcomas of the head and neck[J]. World J Clin Oncol, 2014, 5(5): 973-981. doi:10.5306/wjco.v5.i5.973
[13] Radak M, Ghamari N, Fallahi H. Identification of common factors among fibrosarcoma, rhabdomyosarcoma, and osteosarcoma by network analysis[J]. Biosystems, 2024, 235: 105093. doi:10.1016/j.biosystems.2023.105093
[14] Coca-Pelaz A, Mkitie AA, Strojan P, et al. Radiation-induced sarcomas of the head and neck: a systematic review[J].Adv Ther, 2021, 38(1): 90-108. doi:10.1007/s12325-020-01556-y
[15] Warren D, Koch C, Parsons MS, et al. Head and neck sarcoma tumor board survival guide for neuroradiologists: imaging findings, history, and pathology[J].Curr Probl Diagn Radiol, 2023, 52(4): 275-288. doi:10.1067/j.cpradiol.2023.01.006
[16] 朱培培, 王坚. 特发于头颈部的软组织肿瘤[J]. 临床与实验病理学杂志, 2023, 39(10): 1159-1165. doi:10.13315/j.cnki.cjcep.2023.10.002 ZHU Peipei, WANG Jian. Soft tissue tumor especially in head and neck[J]. Chinese Journal of Clinical and Experimental Pathology, 2023, 39(10): 1159-1165. doi:10.13315/j.cnki.cjcep.2023.10.002
[17] 申园园, 王刘中, 曹华. 5例成人喉部横纹肌肉瘤的临床分析[J]. 临床耳鼻咽喉头颈外科杂志, 2023, 37(12): 1014-1018. doi:10.13201/j.issn.2096-7993.2023.12.018 SHEN Yuanyuan, WANG Liuzhong, CAO Hua. Clinical analysis of 5 cases of adult laryngeal rhabdomyosarcoma[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2023, 37(12): 1014-1018. doi:10.13201/j.issn.2096-7993.2023.12.018
[18] 黄桂球, 叶飞, 傅敏仪, 等. 头颈部低级别肌纤维母细胞肉瘤的临床特点与分析[J]. 临床耳鼻咽喉头颈外科杂志, 2014, 28(15): 1148-1150. doi:10.13201/j.issn.1001-1781.2014.15.014 HUANG Guiqiu, YE Fei, FU Minyi, et al. Clinical analysis of low grade myofibroblastic sarcoma in head and neck[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2014, 28(15): 1148-1150. doi:10.13201/j.issn.1001-1781.2014.15.014
[19] 魏博, 潘馨梦, 尹娇, 等. 原发性甲状腺平滑肌肉瘤1例[J]. 医学影像学杂志, 2023, 33(10): 1759, 1764. WEI Bo, PAN Xinmeng, YIN Jiao, et al. Primary thyroid leiomyosarcoma: one case report[J]. Journal of Medical Imaging, 2023, 33(10): 1759, 1764.
[20] 马妍, 郭凌川, 黄山, 等. 多形性横纹肌肉瘤临床病理特征分析[J]. 中国临床医学, 2024, 31(1): 100-105. doi:10.12025/j.issn.1008-6358.2024.20231559 MA Yan, GUO Lingchuan, HUANG Shan, et al. Clinicopathologic analysis of pleomorphic rhabdomyosarcoma[J]. Chinese Journal of Clinical Medicine, 2024, 31(1): 100-105. doi:10.12025/j.issn.1008-6358.2024.20231559
[21] 李玲, 李聪, 孙岩, 等. 婴儿中耳胚胎型横纹肌肉瘤1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 55-59. doi:10.6040/j.issn.1673-3770.0.2021.409 LI Ling, LI Cong, SUN Yan, et al. A case of an infant with embryonal rhabdomyosarcoma in the middle ear and literature review[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 55-59. doi:10.6040/j.issn.1673-3770.0.2021.409
[22] 刘毅博, 吴迪, 伦晓涵, 等. 舌恶性外周神经鞘膜瘤1例[J]. 华西口腔医学杂志, 2023, 41(3): 361-364. doi:10.7518/hxkq.2023.2022402 LIU Yibo, WU Di, LUN Xiaohan, et al. Malignant peripheral nerve sheath tumor of tongue: a case report[J]. West China Journal of Stomatology, 2023, 41(3): 361-364. doi:10.7518/hxkq.2023.2022402
[23] Masadah R, Jufri NI, Ahmad DE, et al. A rare nasal fibrosarcoma: a case report[J]. Int J Surg Case Rep, 2024, 114: 109160. doi:10.1016/j.ijscr.2023.109160
[24] Kobayashi K, Hanai N, Yoshimoto S, et al. Current topics and management of head and neck sarcomas[J]. Jpn J Clin Oncol, 2023, 53(9): 743-756. doi:10.1093/jjco/hyad048
[25] Casey DL, Wolden SL. Rhabdomyosarcoma of the head and neck: a multimodal approach[J]. J Neurol Surg B Skull Base, 2018, 79(1): 58-64. doi:10.1055/s-0037-1617450
[26] 陈一铭, Ahmed, 季彤, 等. 101例头颈部横纹肌肉瘤临床、病理及预后分析[J]. 中国口腔颌面外科杂志, 2022, 20(2): 146-150. doi:10.19438/j.cjoms.2022.02.008
[27] Rastatter JC, Sinard RN, Dilger A, et al. Survival of patients with non-rhabdomyosarcoma soft tissue sarcomas of the head and neck[J]. Laryngoscope, 2021, 131(2): 500-508. doi:10.1002/lary.28789
[28] 杨征, 房居高, 钟琦,等. 成人喉部横纹肌肉瘤临床分析[J]. 中国耳鼻咽喉头颈外科, 2017, 24(6): 275-278. doi:10.16066/j.1672-7002.2017.06.001 YANG Zheng, FANG Jugao, ZHONG Qi, et al. Clinical analysis of adult rhabdomyosarcoma of the larynx[J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2017, 24(6): 275-278. doi:10.16066/j.1672-7002.2017.06.001
[29] Behranwala KA, A'Hern R, Omar AM, et al. Prognosis of lymph node metastasis in soft tissue sarcoma[J]. Ann Surg Oncol, 2004, 11(7): 714-719. doi:10.1245/ASO.2004.04.027
[30] Gusho CA, Fice MP, O'Donoghue CM, et al. A population-based analysis of lymph node metastasis in extremity soft tissue sarcoma: an update[J]. J Surg Res, 2021, 262: 121-129. doi:10.1016/j.jss.2021.01.005
[31] Basile G, Mattei JC, Alshaygy I, et al. Curability of patients with lymph node metastases from extremity soft-tissue sarcoma[J]. Cancer, 2020, 126(23): 5098-5108. doi:10.1002/cncr.33189
[32] Van Damme JP, Schmitz S, Machiels JP, et al. Prognostic factors and assessment of staging systems for head and neck soft tissue sarcomas in adults[J]. Eur J Surg Oncol, 2010, 36(7): 684-690. doi:10.1016/j.ejso.2010.05.020
[1] 李赞,卢奇,申卫东,侯昭晖,吴南. 坏死性外耳道炎临床诊治18例[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 17-22.
[2] 黄佳丽,刘梓琪,徐娟,陈曦,张立庆,周涵. 咽部梭形细胞鳞状细胞癌的临床及预后分析[J]. 山东大学耳鼻喉眼学报, 2025, 39(2): 94-100.
[3] 李美辰,陈海玲,李阳,马登殿. 下鼻甲黏液囊肿1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2024, 38(5): 91-94.
[4] 杨开炎, 唐凤珠, 覃启才, 李旭祥, 冯大益, 农丰靖, 杨秋云. 异常纺锤体样小头畸形相关蛋白在鼻咽癌中的表达及其临床意义[J]. 山东大学耳鼻喉眼学报, 2024, 38(3): 18-25.
[5] 王凯健,陈雪生,王威. 血小板-淋巴细胞比值与喉鳞状细胞癌预后相关性的Meta分析[J]. 山东大学耳鼻喉眼学报, 2024, 38(3): 67-73.
[6] 张佳佳,石安妮,邢御,洪玉颖,白鹏. 针刺联合西药治疗全聋型突发性聋1例与文献复习[J]. 山东大学耳鼻喉眼学报, 2024, 38(3): 88-92.
[7] 张永红,张辉,王彩华,杨欣欣,吴允刚,赵玉凤,庞太忠,李晓瑜. 基于TCGA数据库构建喉鳞状细胞癌免疫相关基因预后模型及筛选靶向分子药物[J]. 山东大学耳鼻喉眼学报, 2023, 37(5): 54-62.
[8] 刘楠,逄明杰. 鼻内镜泪囊鼻腔吻合术预后影响因素的研究进展[J]. 山东大学耳鼻喉眼学报, 2023, 37(5): 149-155.
[9] 吴波,黄天德,闫斌,陈伊,汤勇. 焦虑抑郁状态与特发性耳鸣预后的相关性研究[J]. 山东大学耳鼻喉眼学报, 2023, 37(4): 46-52.
[10] 孙永强,宋忠义,王春芳,李晓,傅莹,潘新良. 镫骨肌反射阈存在的突聋患者预后及影响因素[J]. 山东大学耳鼻喉眼学报, 2023, 37(2): 7-14.
[11] 韩飞燕,王英. 鼻腔鼻窦神经鞘瘤13例临床分析[J]. 山东大学耳鼻喉眼学报, 2023, 37(2): 21-25.
[12] 姜超,周炫辰,韩杰,岳志勇. IVc期下咽癌特征分析及列线图预后模型构建[J]. 山东大学耳鼻喉眼学报, 2022, 36(4): 49-54.
[13] 程瑶,张震,杨吉,冯成敏,邓启成,张西,赵锐,朱鑫,吴俊志,刘海,邓世山. CIP2A在下咽癌中的表达及临床意义[J]. 山东大学耳鼻喉眼学报, 2022, 36(2): 40-44.
[14] 刘盼,王川,赵泽祺,吴梅,徐继峰,李巍,张伟强,刘稳. 头颈部转移性透明细胞癌5例并文献复习[J]. 山东大学耳鼻喉眼学报, 2021, 35(4): 45-50.
[15] 王中卫,杨林,郭亚,孙斌,王亚利,马秀龙,任宏涛,包兴. 鼻咽癌患者miR-429、miR-200C表达与预后关系分析[J]. 山东大学耳鼻喉眼学报, 2021, 35(3): 81-86.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
网站版权所有 © 2018 《山东大学耳鼻喉眼学报》编辑部　
地址：山东省济南市山大南路27号（250100）电话：+86-0531-88366912 E-mail: ebhxb@sdu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发