摘要
目的探讨发生于颅内脊索瘤的临床表现、影像学特点、组织学类型、手术方法、辅助治疗及远期预后。方法回顾性总结分析67例颅内脊索瘤患者的临床资料,并介绍2例斜坡复发脊索瘤。结果发生于颅底鞍斜区的脊索瘤临床表现复杂,主要表现为颅内站位效应及肿瘤对周围神经损害,首发症状以头痛、视力下降、耳鸣、耳聋及后组颅神经受损症状为主,病理分型:普通型即经典型脊索瘤56例,软骨型脊索瘤8例,去分化型3例。影像学表现67例患者均行CT及MRI检者表现为欠规则肿块影,以膨胀性生长为主,颅底多有骨质破坏肿块与周围软组织边界清楚,2、5年复发率为37.3%、67.1%。结论手术治疗为主要方法,但术后复发率高,根据病变位置、涉及范围选择不同手术入路,必要时联合入路可增加全切几率,尽可能全切除肿瘤对预后至关重要,术后放疗可延缓肿瘤复发时间、减少复发率。
Objective To review summarily the clinical manifectation symptom,radiological characteristics,histopathological type,surgical method,adjuvant therapy and long?term prognosis of intracranial chordoma.Methods Retrospective analysis the clinical data of67patients with intracranial chordoma.Results The clinical manifestations occurred of the skull base chordoma were complex,mainly for intracranial stance effect and peripheral nerve injury.The first manifectation were headaches,vision loss,tinnitus,deafness and the damage symptoms of lower cranial nerves.Pathological type concluded56cases of typical chordoma,8cases of cartilaginiform chordoma and3cases of differentiation type.The dilatant image of parenchyma was the feature in CT or MRI scan and the images often had clear confines.And most of the67cases had destruction of bone.Two?,five?year recurrence rate were37.3%,67.1%,respectively.Conclusion Surgical treatment was the main method,but postoperative recurrence rate was high.Optimal approach was based on the lesion location,range and the joint approach increased the probability of total resection.Total resection of the tumor was very important to prognosis.Postoperative radiotherapy could delay the tumor recurrence time.
作者
李中振
郭芳
王焕宇
LI Zhongzhen;GUO Fang;WANG Huanyu(Department of Neurosurgery,Huanhu Hospital of Tianjin,Tianjin 300350)
出处
《岭南现代临床外科》
2017年第5期587-589,共3页
Lingnan Modern Clinics in Surgery
关键词
颅内肿瘤
脊索瘤
临床治疗
intracranial tumor
chordoma
treatment
