儿童声带颗粒细胞瘤2例临床特征分析

Clinical characteristics analysis of two cases of pediatric vocal cord granulosa cell tumor

  • 摘要: 目的:分析儿童声带颗粒细胞瘤(GCT)的临床特征。方法:回顾性分析2013年1月至2023年12月西安交通大学第二附属医院收治的2例儿童声带GCT患者的临床资料。结果:病例1,女,6岁,因"发声无力3月余"入院,喉镜提示声门下弥漫性膨隆,颈部增强CT提示前联合下方低密度结节并渐进性强化;患儿在全麻下行支撑喉镜CO2激光切除术,术后病理确诊GCT;术后1个月至术后2年复查,肿物无复发,术区局部瘢痕形成,但无明显黏连,声门闭合可。病例2,女,11岁,因"声嘶半年余"入院,喉镜提示前联合光滑肿物,颈部增强CT及喉部增强MRI提示前联合强化结节;患儿在全麻下行支撑喉镜CO2激光切除术,术后病理确诊GCT,术后2周至术后1年复查,肿物无复发,声门下瘢痕形成,声门闭合良好。结论:儿童声带GCT常表现为发音异常,需依靠病理确诊;手术切除为其主要治疗方法,术后应密切随访。

     

    Abstract: Objective:To analyze the clinical characteristics of granulosa cell tumor (GCT) in the vocal cords in children. Methods:The clinical data of 2 children with vocal cord GCT admitted to the Second Affiliated Hospital of Xi'an Jiaotong University from January 2013 to December 2023 were retrospectively analyzed. Results:Case 1, a 6-year-old female, was admitted with a chief complaint of vocal weakness for over 3 months. Under laryngoscopy, diffuse swelling was observed beneath the glottis. Enhanced CT of the neck indicated low-density nodules below the anterior commissure and progressive enhancement. The patient underwent CO2 laser resection under general anesthesia with a supportive laryngoscope, and the postoperative pathological diagnosis was GCT. The patient underwent follow-up examinations at 1 month and 2 years after surgery, and no recurrence of tumor was found, only local scars formed in the laryngeal cavity without obvious adhesions and with good glottal closure. Case 2, an 11-year-old female, was admitted with a chief complaint of hoarseness for over 6 months. Under laryngoscopy, a smooth mass was observed in the anterior commissure. Enhanced CT and MRI of the neck showed a nodular with enhancement in the anterior commissure. The patient underwent CO2 laser resection under general anesthesia with a supportive laryngoscope. The postoperative pathological diagnosis was GCT. Follow-up examinations at 2 weeks and 1 year after surgery showed no recurrence of tumor but scar formation under the glottis with good glottal closure. Conclusion:GCT of the vocal cords in children often presents with disordered voice production, which requires to be confirmed by pathological diagnosis. Surgical resection is the main treatment method, and close follow-up should be paid attention to after surgery.

     

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