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目的探讨儿童鼻咽癌的临床特征,影像学表现及误诊误治原因。方法回顾性分析经确诊的12例儿童鼻咽癌的临床特征、影像学表现,误诊误治原因及确诊方法。结果临床多以颈部肿块(8例),头痛(6例),鼻塞、鼻衄(5例),耳鸣、耳痛、听力下降(4例),面部疼痛(3例),视力下降、复视或斜视(3例)等为首发症状,部分患儿出现2种以上症状(8例)。影像学表现为鼻咽部不规则软组织肿块或软组织不同程度增厚,邻近组织受侵,周围淋巴结肿大,颅底骨破坏和颅内蔓延。增强扫描肿瘤呈不同程度强化。误诊10例,其中误诊为颈淋巴结结核者4例,血管神经性头痛3例,鼻窦炎2例,中耳炎1例。结论影像学检查是诊断儿童鼻咽癌的重要方法,认识不足和首发症状不典型是误诊的主要原因。
Objective To investigate the clinical features, imaging findings and the causes of misdiagnosis and mistreatment in children with nasopharyngeal carcinoma. Methods Retrospective analysis of 12 cases of children diagnosed with nasopharyngeal carcinoma clinical features, imaging findings, the causes of misdiagnosis and diagnosis and diagnosis. Results Most of the patients had neck mass (8 cases), headache (6 cases), nasal obstruction, epistaxis (5 cases), tinnitus, earache, hearing loss in 4 cases, facial pain in 3 cases, Visual or strabismus (3 cases) as the first symptom, some children appear more than 2 kinds of symptoms (8 cases). Imaging findings of irregular nasopharyngeal soft tissue mass or varying degrees of soft tissue thickening, adjacent tissue invasion, peripheral lymph nodes, skull base destruction and intracranial spread. Enhanced scan of the tumor was enhanced to varying degrees. Misdiagnosis in 10 cases, of which misdiagnosed as cervical lymph node tuberculosis in 4 cases, vascular neuropathic headache in 3 cases, 2 cases of sinusitis, otitis media in 1 case. Conclusion Radiographic examination is an important method to diagnose nasopharyngeal carcinoma in children. The lack of knowledge and atypical first symptom are the main causes of misdiagnosis.