Analysis Of Clinical Data Of Inflammatory Myofibroblastic Tumors Of Head And Neck

ObjectiveBy analyzing the clinical data of 5 cases of inflammatory myofibroblastic tumors of head and neck,and combining with the review of relevant literature,the clinical characteristics,auxiliary examination,treatment plan and prognosis of this disease were further discussed,so as to provi de certain reference value for the clinical diagnosis and treatment of this disease.MethodsThe clinical data of 5 cases of IMTs of head and neck treated in the second hospital of Jilin University from January 2009 to November 2018 was retrospectively summarized and analyzed,including general clinical data,clinical manifestations,adjuvant examination,treatment and prognosis.ResultsThere are 5 patients with IMT diagnosed by pathology,4 patients are male and 1 patient is female,aged 36-68,and the average age is 49.2.The site of the disease:2 cases of larynx,1 case of middle ear and mastoid process,1 case of oropharynx,1 case of nasal cavity and sinus.The lesions in the throat were characterized by foreign sensation,sore throat,dyspnea,hoarseness,dysphagia,etc.The lesions in the middle ear were characterized by pus in the ear,hearing loss and facial paralysis.And the lesions in the nasal cavity and sinuses were characterized by facial pain.The tumor showed smooth mass or granulation.The CT scan of laryngeal IMT showed only soft tissue density,no specific manifestation,and CT enhancement showed uneven enhancement.CT scan of IMT of middle ear and maxillary sinus showed soft tissue density shadow with bone destruction.MRI of IMT of maxillary sinus showed long T1 long T2 signal shadow.Case 1 underwent resection of laryngeal mass under supportive laryngoscope,and the cutting edge was treated with electric knife.Case 2 underwent radical right mastoidectomy and right external auditory meatoplasty.Case 3 underwent pharyngeal mass resection at low temperature plasma,and the lesion was completely removed.Biopsy was performed under the supportive laryngoscopy in Case 4,and two intraoperative examinations were submitted for rapid pathology,which showed squamous epithelial hyperplasia,with a large amount of necrotic tissue and exudation.It was considered inflammatory lesion and no special treatment was done.After the operation,anti-infection,rehydration and other symptomatic support treatment were given.Case 5 was treated with steroid hormone therapy and surgery.Case 1 postoperative follow-up so far,no recurrence.Case 2 had recurrence 10 months after operation,and died 13 months after operation because of the deterioration of the disease.Case 3 and case 4 postoperative follow-up so far,cured,no recurrence.Case 5 had recurrence 1 month after operation,again performed partial maxillary excision,the patient refused postoperative radiotherapy,followed up for 7 months,bilateral vision loss,death.Conclusions1.Head and neck IMT is rare,its clinical symptoms and imaging manifestations lack specificity,diagnosis depends on pathological examination,complete surgical resection is the preferred treatment for IMT,if the cutting edge is positive,further treatment such as radiotherapy,chemotherapy,ALK molecular targeted drugs or steroid hormones can be selected.2.Biological properties of most IMT of larynx tend to be benign,the prognosis is good after complete surgical resection.In addition,simple anti-infection treatment also has a certain positive and effective effect,under the condition that the patient’s condition permits,that is,the tumor has no malignant tendency,anti-infection conservative treatment can be carried out first to observe the changes of the lesion,if the lesion has no obvious signs of regression,surgical treatment can be carried out again,and long-term follow-up should be conducted after the operation.3.Sinus IMT and middle ear IMT are highly invasive,and the prognosis of single surgical treatment is poor,which can be combined with steroid hormones,radiotherapy and chemotherapy,etc.