儿童喉部肿瘤：良性与恶性肿瘤的系统综述。

文献信息

中文摘要

背景： 儿童喉部肿瘤极为罕见，涵盖一组异质性很强的良性和恶性肿瘤。现有证据仍主要局限于病例报告和小型病例系列。
目的： 系统描述儿童良性和恶性喉部肿瘤的组织病理学、临床表现、治疗、复发及结局特征。
方法： 按照PRISMA指南开展系统综述。检索MEDLINE、Embase、ScienceDirect和Cochrane Library中2000年1月至2026年7月发表的、涉及年龄≤18岁且经组织学确诊为原发性喉部肿瘤患者的研究。
结果： 共纳入86项研究。在52例良性肿瘤患者中，颗粒细胞瘤是最常见的诊断，其次为神经纤维瘤和炎性肌纤维母细胞瘤。声嘶是主要症状，手术尤其是内镜下切除是主要治疗方式。在有结局数据的44例患者中，7例（15.9%）发生复发。在69例恶性或中间型肿瘤患者中，鳞状细胞癌占主导，其次为肉瘤和淋巴瘤。治疗根据组织学和疾病范围包括手术、放疗和化疗。9例患者接受了全喉切除术，报告了12例死亡。
结论： 儿童喉部肿瘤罕见，但对于持续或进行性声嘶、呼吸困难、吞咽困难或其他无法解释的上气道症状的儿童，应考虑该病。颗粒细胞瘤和神经纤维瘤是主要的良性病变，而鳞状细胞癌是最常报告的恶性肿瘤。鉴于这些肿瘤的罕见性以及目前对基于病例证据的依赖，有必要建立国际多中心登记系统，以产生更高质量的数据，并为儿童喉部肿瘤的标准化诊断和治疗算法提供依据。

英文摘要

BACKGROUND: Pediatric laryngeal tumors are exceptionally rare and encompass a heterogeneous spectrum of benign and malignant neoplasms. Evidence remains largely limited to case reports and small case series.
OBJECTIVE: To systematically characterize the histopathology, clinical presentation, treatment, recurrence, and outcomes of benign and malignant laryngeal tumors in children.
METHODS: A systematic review was conducted according to PRISMA guidelines. MEDLINE, Embase, ScienceDirect, and the Cochrane Library were searched for studies published from January 2000 to July 2026 involving patients aged ≤18 years with histologically confirmed primary laryngeal tumors.
RESULTS: Eighty-six studies were included. Among 52 patients with benign tumors, granular cell tumor was the most frequent diagnosis, followed by neurofibroma and inflammatory myofibroblastic tumor. Hoarseness was the predominant symptom, and surgery, particularly endoscopic resection, was the principal treatment. Recurrence occurred in 7/44 patients (15.9%) with available outcome data. Among 69 patients with malignant or intermediate tumors, squamous cell carcinoma predominated, followed by sarcomas and lymphomas. Treatment included surgery, radiotherapy, and chemotherapy according to histology and disease extent. Total laryngectomy was performed in nine patients, and 12 deaths were reported.
CONCLUSIONS: Pediatric laryngeal tumors are rare, but should be considered in children with persistent or progressive hoarseness, dyspnea, dysphagia, or other unexplained upper airway symptoms. Granular cell tumor and neurofibroma were the predominant benign lesions, whereas squamous cell carcinoma was the most frequently reported malignant neoplasm. Given the rarity of these tumors and the current reliance on case-based evidence, the establishment of international multicenter registries is warranted to generate higher-quality data and inform standardized diagnostic and therapeutic algorithms for pediatric laryngeal neoplasms.