鼻腔鼻窦畸胎癌肉瘤的调强放射治疗.pptxVIP

鼻腔鼻窦畸胎癌肉瘤的调强放射治疗第1页/共30页 Treatment of sinonasal teratocarcinosarcoma using IMRT第2页/共30页 Introduction Case Discussion 第3页/共30页 casediscussionintroductionSNTCS sino nasal terato carcino sarcoma 80 cases reported 第4页/共30页 casediscussionintroductionHistoryVencent J. HyamsDirector of the Otolaryngic Pathology branch of the Armed Forces Institute of Pathology，1968-1984 Teratoid carcinosarcoma ?Mixed mesodermal tumour ? Malignant teratoma and blastomas ?1984第5页/共30页 casediscussionintroductionCharacteristicsT1-weighted MR reveals a soft tissue filling the left ethmoid sinus, as uniformly high signal (*), and effusion (white arrowhead) in the left sphenoid sinus. Takasaki, K.,2006Epithelial glandular carcinoma (at right) and osteosarcoma component (at left). (hematoxylin-eosin, original magnification?x40). Smith, S. L.,2008Endoscopic examination showing a left sinonasal tumor in the left middle turbinate. M, middle turbinate; S, nasal septum. Su, Y. Y., 2010CBA第6页/共30页 TreatmentcasediscussionintroductionPatients generally present with locally advanced-stage diseasethe highly malignant, aggressive biological behavior the presence of air filled paranasal spaces permits silent growth Distant metastasis of SNTCS is unusual and the most common cause of treatment failure is local recurrenceSurgical excision?and postoperative radiotherapy has become the most?widely accepted therapeutic plan 第7页/共30页 Introduction Case Discussion 第8页/共30页 HPIintroductiondiscussioncase42-year-old man Two weeks history of progressive left nasal obstruction and intermittent nasal bleedingNasal examination showed a moderately firm, reddish-purple mass in the left meatusBiopsy of the tumor revealed a heterogeneous admixture of epithelial and mesenchymal elements, suggesting SNTCSTeratocarcinosarcoma Teratocarcinosarcoma consists of two components, epithelial and mesenchymal (hematoxylin-eosin, original magnification ×200)第9页/共30页 cT3N0M0MRIintroductiondis