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目的分析以颅底病变为主的鼻咽癌患者误诊的原因。方法回顾性分析1992年1月至2009年12月诊治的12例以颅底病变为主的鼻咽癌误诊患者的临床资料,并对误诊疾病及误诊原因进行分析。结果 12例以颅底病变为主的鼻咽癌误诊患者中,有7例(58.3%)误诊为颅底脊索瘤,3例(25.0%)误诊为蝶窦恶性肿瘤,1例(8.3%)误诊为垂体瘤,1例(8.3%)误诊为脑膜瘤。结论对上行型、黏膜下型鼻咽癌特征认识不足、影像学检查部位或检查方法不准确是鼻咽癌误诊主要原因。提高对以颅底病变为主鼻咽癌的认识,重视鼻咽部和颅底的影像学检查,以及鼻咽部多次活检可以降低鼻咽癌的误诊。
Objective To analyze the causes of misdiagnosis of patients with nasopharyngeal carcinoma based on skull base lesions. Methods The clinical data of 12 patients with nasopharyngeal carcinoma misdiagnosed as skull base lesions from January 1992 to December 2009 were analyzed retrospectively. The causes of misdiagnosis and misdiagnosis were analyzed. Results Of the 12 patients with nasopharyngeal carcinoma misdiagnosed as skull base lesions, 7 (58.3%) were misdiagnosed as skull base chordomas, 3 (25.0%) were misdiagnosed as sphenoid sinus malignancies, 1 (8.3% Misdiagnosed as pituitary tumor, 1 case (8.3%) misdiagnosed as meningioma. Conclusions The lack of understanding of the characteristics of the up and submucous nasopharyngeal carcinoma, the main reason for the misdiagnosis of nasopharyngeal carcinoma is the imaging examination site or the inaccurate examination method. To improve understanding of skull base lesions based nasopharyngeal carcinoma, nasopharynx and skull base attention to imaging studies, and nasopharyngeal multiple biopsy can reduce the misdiagnosis of nasopharyngeal carcinoma.