Computed Tomography Evaluation of Retroperitoneal Hemangiopericytomas

後腹腔血管外皮細胞瘤之電腦斷層評估

陳肇長(Siu-Cheung Chan) ； 張潤忠(Yun-Chung Cheung) ； 高常發(Sheung-Fat Ko) ； 張良慈(Liang-Tzu Chang) ； 吳冠群(Koon-Kuan Kg) ； 呂嘉偉(Kar-Wai Lui) ； 黃浩輝(Ho-Fai Wong) ； 吳樹鏗(Shu-Hang Ng)

《中華放射線醫學雜誌》 28卷4期 (2003/08) Pp. 231-236

摘要

由1992至1996年，本院共發現了四位患有後腹腔血管外皮細胞瘤的病人，其中三位女性及一位男性，年齡在34歲至50歲。我們回顧及分析這四位病人的臨床症狀、電腦斷層影像、病理診斷、治療方法及其預後追蹤等。四例中，有兩例來自腹部後腹腔，兩例來自骨盆後腹腔。發覺這些腫瘤有頗整齊的邊緣，體積巨大（其中三例的最大長度超過14公分）而導致排擠但沒有侵犯其週邊的器官，沒有腹腔骨盆腔內器官及淋巴結的轉移；兩例腹部後腹腔及一例骨盆後腹腔血管外皮細胞瘤在注射造影劑的電腦斷層影像中，有不均勻的顯影及壞死組織，其餘一例骨盆後腹腔血管外皮細胞瘤則有強烈的顯影而沒有明顯的壞死組織，四例腫瘤在電腦斷層影像中均沒有鈣化。四位病人都接受外科手術切除腫瘤，經病理檢查確定為惡性血管外皮細胞瘤。其後經過五年的手術後追蹤，均沒有發現復發跡象。
後腹腔血管外皮細胞瘤是一罕見的疾病，在電腦斷層掃描檢查中若發現有一邊緣完整，注射造影劑後有良好顯影及壞死組織的腫瘤時，血管外皮細胞瘤應列入鑑別診斷，此外，電腦斷層掃描也是決定治療計劃及預後追蹤的重要工具。

關鍵字

後腹腔 ； 血管外皮細胞瘤 ； 電腦斷層掃描

並列摘要

Between January 1992 to December 1996, four patients with pathology-proven malignant retroperitoneal hemangiopericytomas were seen at our hospital. The clinical presentation, CT and pathological findings, treatment and outcome were reviewed. Two of the four hemangiopericytomas were found in abdominal retroperitoneum and the others in the pelvic retroperitoneum. The tumors were shown to have smooth margin, tended to be large (three of them were larger than 14 cm in its longest dimension) enough to displace but not invade the adjacent organs. The two abdominal hemangiopericytomas and one of the pelvic hemangiopericytomas showed heterogeneous enhancement with necrotic components in enhanced CT scan, the other one of pelvic hemangiopericytomas showed strong homogeneous enhancement without obvious necrotic component. In none of the patients, regional lymph node or intraabdominal metastasis was shown in the CT study. No recurrence was found in all of the patients followed up to 5 years after surgery.
Although hemangiopericytoma is a rare disease, it should be considered when a huge encapsulated retroperitoneal mass with strong enhancement and necrotic components is shown in CT scan study

並列關鍵字

Computed tomography ； Hemangiopericytoma ； Retroperitoneum