目的：探讨颈动脉间隙平滑肌瘤的临床表现、影像和病理特征及其鉴别诊断。方法回顾性分析1例经手术病理证实的颈动脉间隙平滑肌瘤病人的影像及病理资料，并复习相关文献。结果 CT检查显示左侧颈动脉间隙不规则囊实性、多房样肿物，大小约7.5 cm×6.0 cm×4.0 cm，增强检查示病灶实性成分及内部分隔明显强化，其中可见左颈动脉穿行，邻近胸锁乳突肌、颌下腺及左侧咽侧壁受压移位。术中观察肿物呈囊性，边界清，表面光滑，与颈浅部肌肉、血管及神经关系密切。病理诊断为梭形细胞肿瘤；免疫组织化学显示SMA（+），提示平滑肌瘤伴部分囊性变。结论颈动脉间隙平滑肌瘤罕见，临床及影像表现通常无特异性，确切诊断需依靠病理学与免疫组织化学检查。%Objective To evaluate the clinical manifestations, imaging and histological findings, differential diagnosis of leiomyoma in carotid space. Methods A case of leiomyoma in carotid space proved by histology was retrospectively analysed, and literature were reviewed. Results CT scan revealed an irregular cystic-solid and multilocular mass in the left carotid space which showed markedly enhanced solid component and inner septums. The size of the mass was 7.5 cm × 6.0 cm × 4.0 cm. The left carotid artery was embedded in the tumor and adjacent sternocleidomastoid muscle, submandibular gland, left lateral pharyngeal wall were compressed and displaced. The mass showed cystic, smooth and well-defined by intraoperative observation. There was a close relationship between the mass and superficial muscle, vessels and nerves. Pathological diagnosis:spindle cell tumor. Immunohistochemistry showed SMA(+), suggesting leiomyoma with partial cystic degeneration. Conclusion Leiomyoma in carotid space is rare and usually does not have specific clinical and imaging manifestation. Definite diagnosis depends on the pathological and immunohistochemical examination.
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