內視鏡手術切除晚期鼻咽部血管纖維瘤──病例報告

Endoscopic Surgery for Advanced Nasopharyngeal Angiofibroma : A Case Report

鼻咽部血管纖維瘤是少見的良性腫瘤，好發於年輕男性。具有局部侵犯的特性。治療的原則以手術切除為主。從1996年起，陸續有學者以鼻內視鏡手術來治療早期鼻咽部血管纖維瘤，預後良好。對晚期的病例則仍無法突破。本院有一名13歲男孩，是屬於Chandler分類之第三期鼻咽部血管纖維瘤。術前安排核磁共振及動脈血管攝影並且同時將供應腫瘤的血管栓塞後，施行內視鏡手術，成功地將血管纖維瘤切除，術後長期追蹤無局部復發。對於晚期之鼻咽部血管纖維瘤，經鼻內視鏡手術亦是一種可嘗試的方法。

Nasopharyngeal angiofibroma is a rare disease that occurs in adolescent males. It is a benign tumor but shows aggressive local invasion and surgery is the most effective method of treatment. Since 1996, many authors have reported that endoscopic treatment of early nasopharyngeal angiofibroma has shown excellent results. It is difficult to perform endoscopic surgery for advanced nasopharyngeal angiofibroma. We report a case of a 13-year-old boy whose nasopharyngeal angiofibroma was at stage III according to Chandler's classification. We arranged for an MRI and angiography with embolization before the operation and removed the tumor by endoscope. No recurrence was noted during a 7 year follow-up period. We conclude that endoscopic treatment is an appropriate method for removal of an advanced angiofibroma.