PATHOLOGY OF SECONDARY MALIGNANT TUMORS OF TEMPORAL BONE
PATHOLOGY OF SECONDARY MALIGNANT TUMORS OF TEMPORAL BONE
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DOI：
10.1177/000348946807700101
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发表时间：
1968-01-01
影响因子：
1.4
通讯作者：
MURAKAMI, Y
中科院分区：
文献类型：
--
作者：
SCHUKNECHT, HF;ALLAM, AF;MURAKAMI, Y
描述了对 10 名继发性恶性疾病患者颞骨的组织病理学研究，并回顾了文献。颞骨继发性恶性肿瘤相对不常见，但其发病率可能比文献综述显示的要高得多，因为耳科症状并不严重致残，并且被其他转移性病变所掩盖。颞骨的放射学检查和组织学研究很少作为可能患有转移性疾病的患者的常规程序进行。最常见的颞骨继发性恶性肿瘤是乳腺癌、肾细胞癌和支气管癌。转移性肿瘤通常通过血行播散侵入颞骨。来自邻近区域的直接肿瘤侵袭也沿着阻力最小的平面或沿着自然通道发生，例如，咽鼓管、颈动脉管和内耳道。尽管转移性病变在组织学外观上可能与原发肿瘤相似，但它通常分化较差。通常，除了分化良好的肿瘤（如肾细胞癌）外，不可能通过其组织学外观来识别转移性病变的原发部位。最初，所有颞骨的恶性转移都是破坏性的，但有些随后会发生骨修复。颞骨、耳囊和膜迷路中的神经组织对肿瘤浸润表现出相当大的抵抗力，但尽管如此，这些结构仍可能被侵袭。听力损失是颞骨继发性恶性肿瘤常见的早期表现。传导型听力损失几乎总是由输卵管功能障碍和继发性浆液性中耳炎引起。感音神经性听力损失主要是由于内耳道的耳蜗纤维受压或破坏，也可能是由于耳蜗的直接侵入所致。
A histopatho-logical study of the temporal bones of 10 patients with secondary malignant disease was described and the literature reviewed. Secondary malignant tumors of the temporal bone are relatively uncommon, yet their incidence is probably much higher than the review of the literature suggests as the otological symptoms are not severely disabling and are overshadowed by other metastatic lesions. Radiological surveys and histological studies of the temporal bone are rarely performed as a routine procedure in patients with possible metastatic disease. The most common secondary malignant tumors of the temporal bone arise from mammary carcinoma, renal cell carcinoma, and bronchogenic carcinoma. Metastatic tumors usually invade the temporal bone through hematogenous dissemination. Also direct neoplastic invasion from adjacent areas occurs along planes of least resistance or along natural passages, e.g. the Eustachian tube, carotid canal and internal auditory meatus. Although the metastatic lesion may resemble the primary tumor in histologic appearance, it is often less well-differentiated. Usually it is not possible to identify the primary site of a metastatic lesion by its histological appearance except for well-differentiated neoplasms such as renal cell carcinoma. Originally, all malignant metastases to the temporal bone are destructive, but some are followed by bone repair. The nervous tissue in the temporal bone, the otic capsule and the membranous labyrinth exhibit considerable resistance to neoplastic infiltration but nevertheless these structures may be invaded. Hearing loss is a common early manifestation of secondary malignant tumors of the temporal bone. Conductive type hearing loss is almost always due to tubal dysfunc tion and secondary serous otitis media. Sensorineural hearing loss is mainly due to either compression or destruction of the cochlear fibers in the internal auditory meatus, also it can be due to direct invasion of the cochlea.