囊性脑膜瘤的诊治分析
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摘要
目的总结囊性脑膜瘤的治疗经验。方法回顾性分析2007年1月至2018年1月手术治疗的13例囊性脑膜瘤的临床资料。结果根据Simpson分级,Ⅰ级切除7例,Ⅱ级切除6例。术后病理显示均为脑膜瘤,其中上皮细胞型6例,过渡型3例,纤维型2例,血管型2例。术后随访0.5～11年,平均5.3年;1例复发;1例中残;其余11例均预后良好。结论对于囊性脑膜瘤,在手术安全前提下,尽量全切肿瘤及囊壁,并根据术后病理,决定是否放疗,多数病人可取得良好预后。
Objective To investigate the diagnosis and treatment of cystic meningiomas. Methods The clinical data of 13 patients with cystic meningiomas treated in our department from January, 2007 to January, 2018 were analyzed retrospectively. The diagnosis and treatment characteristics of cystic meningiomas were summarized in combination with literatures. Results Of the 13 patients, 7 received of Simpson gradeⅠresection of the tumors and 6 Simpson grade Ⅱ resection. Postoperative pathological examination showed that of 13 cases of the cystic meningiomas, 6 were meningothelial type, 3 transitional type, 2 fibrous type and 2 angiomatous type. The following up from 6 months to 11 years showed that of 13 patients, 1 had a rellapse, 1 was mildly disabled and 11 were recovered well. Conclusions On the premise of safe operation, the meningiomas and cyst walls should be totally removed as possible. It is decided whether the radiotherapy is performed or not according to the results of the postoperative pathological examination in the patients with cystic meningiomas.
Objective To investigate the diagnosis and treatment of cystic meningiomas. Methods The clinical data of 13 patients with cystic meningiomas treated in our department from January, 2007 to January, 2018 were analyzed retrospectively. The diagnosis and treatment characteristics of cystic meningiomas were summarized in combination with literatures. Results Of the 13 patients, 7 received of Simpson gradeⅠresection of the tumors and 6 Simpson grade Ⅱ resection. Postoperative pathological examination showed that of 13 cases of the cystic meningiomas, 6 were meningothelial type, 3 transitional type, 2 fibrous type and 2 angiomatous type. The following up from 6 months to 11 years showed that of 13 patients, 1 had a rellapse, 1 was mildly disabled and 11 were recovered well. Conclusions On the premise of safe operation, the meningiomas and cyst walls should be totally removed as possible. It is decided whether the radiotherapy is performed or not according to the results of the postoperative pathological examination in the patients with cystic meningiomas.
引文
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[3] Docampo J, Gonzalez N, Vazquez C, et al. Cystic meningio-ma simulating arachnoid cyst:report of an unusual case[J].Case Rep Radiol, 2014, 26(7):115-119.
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[5] Jung TY, Jung S, Shin SR, et al. Clinical and histopathologi-cal analysis of cystic meningiomas[J]. J Clin Neurosci,2005, 12(6):651-655.
[6] Sotiriadis C, Vo QD, Ciarpaglini R, et al. Cystic meningioma:diagnostic difficulties and utility of MRI in diagnosis andmanagement[J]. BMJ Case Rep, 2015, 26(3):1136-1142.
[7] Wang P, Han S, Liu N, et al. Peritumoral cystic meningioma:a report of two cases and review of the literature[J]. ExpTher Med, 2016, 11(3):904-908.
[8] Jimenez O, Nagore N. Cystic lesions associated with intra-cranial meningiomas. Report of three cases[J]. Br J Neuro-surg, 2000, 14(6):595-596.
[9] Chen TY, Lai PH, Ho JT, et al. Magnetic resonance imagingand diffusion-weighted images of cystic meningioma:correlating with histopathology[J].Clin Imaging, 2004, 28(1):10-19.
[10] Amin OS, Shwani SS, Khalifa F. Cystic meningioma[J]. BMJCase Rep, 2015, 11(10):136-139.
[11] Maj B, Latka D, Kita P. Cystic meningioma:report of threecases[J]. Neurol Neurochir Pol, 2002, 36(1):199-206.
[12] Mittal A, Layton KF, Finn SS, et al. Cystic meningioma:un-usual imaging appearance of a common intracranial tumor[J]. Proc(Bayl Univ Med Cent), 2010, 23(4):429-431.
[13] Go KO, Lee K, Heo W, et al. Cystic meningiomas:correla-tion between radiologic and histopathologic features[J].Brain Tumor Res Treat, 2018, 6(1):13-21.
[14]张俊和,赵延峰,郑秉杰,等. 2次复发性囊性脑膜瘤1例[J].中国微侵袭神经外科杂志,2007,12(3):119-120.
[15] Ueno Y, Tanaka A, Nakayama Y, et al. Intracerebral cystassociated with meningioma[J]. Clin Neurol Neurosurg,1999, 101(4):271-274.
[16] Arai M, Kashihara K, Kaizaki Y. Enhancing gliotic cyst wallwith microvascular proliferation adjacent to a meningioma[J]. J Clin Neurosci, 2006, 13(1):136-139.
[17] Boukobza M, Cebula H, Pop R, et al. Cystic meningioma:radiological, histological, and surgical particularities in 43patients[J]. Acta Neurochir(Wien), 2016, 158(10):1955-1964.
[2] Worthington C, Caron JL, Melanson D, et al. Meningiomacysts[J]. Neurology, 1985, 35(12):1720-1724.
[3] Docampo J, Gonzalez N, Vazquez C, et al. Cystic meningio-ma simulating arachnoid cyst:report of an unusual case[J].Case Rep Radiol, 2014, 26(7):115-119.
[4] Zhang D, Hu LB, Zhen JW, et al. MRI findings of intracra-nial cystic meningiomas[J]. Clin Radiol, 2009, 64(8):792-800.
[5] Jung TY, Jung S, Shin SR, et al. Clinical and histopathologi-cal analysis of cystic meningiomas[J]. J Clin Neurosci,2005, 12(6):651-655.
[6] Sotiriadis C, Vo QD, Ciarpaglini R, et al. Cystic meningioma:diagnostic difficulties and utility of MRI in diagnosis andmanagement[J]. BMJ Case Rep, 2015, 26(3):1136-1142.
[7] Wang P, Han S, Liu N, et al. Peritumoral cystic meningioma:a report of two cases and review of the literature[J]. ExpTher Med, 2016, 11(3):904-908.
[8] Jimenez O, Nagore N. Cystic lesions associated with intra-cranial meningiomas. Report of three cases[J]. Br J Neuro-surg, 2000, 14(6):595-596.
[9] Chen TY, Lai PH, Ho JT, et al. Magnetic resonance imagingand diffusion-weighted images of cystic meningioma:correlating with histopathology[J].Clin Imaging, 2004, 28(1):10-19.
[10] Amin OS, Shwani SS, Khalifa F. Cystic meningioma[J]. BMJCase Rep, 2015, 11(10):136-139.
[11] Maj B, Latka D, Kita P. Cystic meningioma:report of threecases[J]. Neurol Neurochir Pol, 2002, 36(1):199-206.
[12] Mittal A, Layton KF, Finn SS, et al. Cystic meningioma:un-usual imaging appearance of a common intracranial tumor[J]. Proc(Bayl Univ Med Cent), 2010, 23(4):429-431.
[13] Go KO, Lee K, Heo W, et al. Cystic meningiomas:correla-tion between radiologic and histopathologic features[J].Brain Tumor Res Treat, 2018, 6(1):13-21.
[14]张俊和,赵延峰,郑秉杰,等. 2次复发性囊性脑膜瘤1例[J].中国微侵袭神经外科杂志,2007,12(3):119-120.
[15] Ueno Y, Tanaka A, Nakayama Y, et al. Intracerebral cystassociated with meningioma[J]. Clin Neurol Neurosurg,1999, 101(4):271-274.
[16] Arai M, Kashihara K, Kaizaki Y. Enhancing gliotic cyst wallwith microvascular proliferation adjacent to a meningioma[J]. J Clin Neurosci, 2006, 13(1):136-139.
[17] Boukobza M, Cebula H, Pop R, et al. Cystic meningioma:radiological, histological, and surgical particularities in 43patients[J]. Acta Neurochir(Wien), 2016, 158(10):1955-1964.