Clinicopathological features of cranial-nasal-orbital communicating lesions and diagnostic indicators for differentiating benign and malignant neoplasms.
Meng Xie, Jin Chen, Ya-Yan You, Zi-Xuan Su, Xi-Yin Zhu, Xing-Hua Wang, Peng-Cheng Li, Fa-Gang Jiang
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引用次数: 0
Abstract
Aim: To investigate the clinicopathological features of cranial-nasal-orbital communicating lesions and identify key diagnostic indicators for differentiating benign and malignant neoplasms.
Methods: The retrospective cohort study analyzed 74 histologically confirmed cases stratified by anatomical involvement at the Wuhan Union Hospital between January 2010 and December 2020: Group A (orbital-nasal group, n=29), Group B (orbital-cranial group, n=27), and Group C (cranial-nasal-orbital group, n=18). Clinicopathological profiles including symptom presentation, histopathology, and invasion patterns were systematically evaluated.
Results: The cohort comprised 49 (66.2%) benign and 25 (33.8%) malignant lesions. Compared with benign lesions, malignant lesions had a shorter onset time (12mo vs 2.5mo, P=0.004) and resulted in poorer vision (0.6 vs 1.53, P=0.025). Headache was reported in 28.6% of patients with benign lesions, but none in those with malignant lesions (P=0.002). Conjunctival congestion and edema were observed in 32.7% of patients with benign lesions and 60% of patients with malignant lesions (P=0.028). The ethmoid sinus was the most frequently invaded site (35 cases). Malignant lesions showed greater invasion in the nasal cavity (28.0% vs 0, P=0.000) and anterior cranial fossa (40.0% vs 8.2%, P=0.003) than benign lesions. The orbital-cranial group was more likely to invade through osseous foramina compared with the orbital-nasal group (P=0.002). Neurogenic tumors predominated benign cases (34.7%), whereas blood derived (28%) and glandular tumors (28%) were most prevalent in malignant subgroups. The proportion of malignant tumors in multi-disciplinary combined surgery was higher than that of benign lesions (61.5% vs 38.5%).
Conclusion: Malignant cranial-nasal-orbital communicating lesions exhibit distinct clinicopathological signatures characterized by rapid progression, aggressive anterior fossa and nasal region, and severe visual morbidity.
目的：探讨颅鼻眶交通病变的临床病理特点，探讨鉴别良恶性肿瘤的关键诊断指标。方法：回顾性队列研究分析2010年1月至2020年12月武汉协和医院按解剖受累分层的74例组织学确诊病例：A组（眶-鼻组，n=29）， B组（眶-颅组，n=27）， C组（颅-鼻-眶组，n=18）。临床病理特征包括症状表现、组织病理学和侵袭模式被系统地评估。结果：本组49例（66.2%）良性病变，25例（33.8%）恶性病变。与良性病变相比，恶性病变发病时间较短（12mo vs 2.5mo， P=0.004），视力较差（0.6 vs 1.53， P=0.025）。28.6%的良性病变患者出现头痛，而恶性病变患者没有出现头痛（P=0.002）。良性病变32.7%，恶性病变60%，结膜充血水肿（P=0.028）。筛窦是最常见的侵犯部位（35例）。恶性病变对鼻腔（28.0%比0，P=0.000）和前颅窝（40.0%比8.2%，P=0.003）的侵犯大于良性病变。眶-颅组较眶-鼻组更容易侵入骨孔（P=0.002）。良性病例以神经源性肿瘤为主（34.7%），恶性亚组以血源性肿瘤（28%）和腺源性肿瘤（28%）最为常见。多学科联合手术中恶性肿瘤的比例高于良性病变（61.5% vs 38.5%）。结论：恶性颅鼻眶交通病变具有明显的临床病理特征，其进展迅速，侵犯前窝和鼻区，严重的视觉损害。
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· International Journal of Ophthalmology-IJO (English edition) is a global ophthalmological scientific publication
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