我们遇到一个早期有明显的钙化作用和骨化作用的颈椎平滑肌瘤病人。通过CT上观察一个68岁男性的左侧颌下区域和纵隔膜上侧区域，确定其左侧颌下出现硬化和肿大区域发现有钙化的结节状病变。细针穿刺活检（FN
我们遇到一个早期有明显的钙化作用和骨化作用的颈椎平滑肌瘤病人。通过CT上观察一个68岁男性的左侧颌下区域和纵隔膜上侧区域，确定其左侧颌下出现硬化和肿大区域发现有钙化的结节状病变。细针穿刺活检（FNAB）检测左侧颌下区域并没有恶性肿瘤。最后的诊断和处理方式还是进行切除去解决。切除的样品包括一个明显钙化且切割面为骨化的固态肿块。其中组织病理学的测试显示增生的梭形细胞呈紊乱的交叉排列。免疫组织化学方面，与平滑肌肉细胞一样，梭形细胞通过α-平滑肌肌动蛋白和H-钙调素结合蛋白去进行着色。这些发现影响了钙化和骨化的平滑肌瘤的最后的诊断结果。这是非常稀少且在手术前非常难以与其他头部或颈部的肿瘤进行区分的一个病例，通过切割颌下腺肿瘤，及组织病理学和免疫组织化学的分析和处理共同确定了这个平滑肌瘤的最终诊断。尽管如此，这个在纵隔膜上侧区域的肿瘤更有可能变成钙化的平滑肌瘤，病人本身并不希望立即去经受活组织检查和切除。我们也还需要继续进一步的跟踪调查。
We encountered a patient with primary cervical leiomyoma with remarkable calcification and ossification. A 68-year-old manpresenting with induration and swelling of the left submandibular region was found to have nodular lesions with calcifications inthe left submandibular region and the upper mediastinumon CT. Fine needle aspiration biopsies (FNAB) of the left submandibular
lesion revealed no malignancy. Resection was performed for definitive diagnosis and treatment. The resected specimen containeda solid tumor, which was markedly calcified and ossified on the cut surface. Histopathological examination showed proliferatingspindle cells in a tangled and crossed arrangement. Immunohistochemically, the spindle cells were stained intensely with 𝛼-SMAand h-caldesmon, consistent with smoothmuscle cells. These findings led to a definitivediagnosis of leiomyoma with calcificationand ossification. This is extremely rare and the preoperative differentiation fromother tumors of the head and neck was very difficult.By resection of the submandibular tumor, both definitive diagnosis of leiomyoma by histopathological and immunohistochemicalanalyses and treatment could be carried out. However, as the tumor in the upper mediastinum was most likely to be leiomyomawith calcification, he did not wish to undergo its biopsy and resection immediately.We have continued the follow-up.
