原发性颅骨内溶骨性脑膜瘤3例报告并文献复习  

Primary intraosseous osteolytic meningomas of the skull:report of three cases and review of the literatures

作　　者：曹磊[1] 张小军[1] 王守森[1] 陈宏颉[1] 高进喜[1] 王如密[1] 

机构地区：[1]南京军区福州总医院神经外科,福州350025

出　　处：《中国临床神经外科杂志》2011年第6期337-339,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨原发性颅骨内溶骨性脑膜瘤的诊断和治疗方法。方法回顾性分析2005年3月至2010年6月收治的3例经病理学证实为原发性颅骨内溶骨性脑膜瘤患者的临床资料,并结合相关文献进行分析。结果 3例患者的肿瘤分别位于鞍结节、顶枕骨和蝶窦大翼内,影像学表现均呈溶骨性破坏,均行手术切除肿瘤。术后病理学结果分别为砂样体型、混合型和纤维型脑膜瘤,周围骨质均受累。1例术后23月复发;另2例随访6月至5年,未见复发。结论原发性颅骨内溶骨性脑膜瘤术前明确诊断有一定难度,确诊依赖于病理学检查;术中冰冻切片病理学检查对决定手术方案有指导价值;最大程度切除肿瘤及受累骨质是治疗的关键。Objective To explore the pathogenesis,diagnosis and treatment of the primary intraosseous osteolytic meningomas of the skull （PIOMS）.Method The clinical data of 3 patients with PIOMS,who were treated in our department from March,2005 to June,2010,were analyzed retrospectively and the literatures related to PIOMS were reviewed.Results Three PIOMS were located respectively in tuberculum sellea,parietoccipital bone and sphenoid wing.All the tumors were of osteolytic characteristics on the images and resected by surgery.The pathohistological examination showed that 3 meningomas were psammomatous,mixed and fibrous ones respectively.The meningoma recurred in 1 patient 23 months after the surgery.Conclusions PIOMS possibly originate from the misplaced intraosseous arachnoid granulation cells.It is difficult to make a definite diagnosis of PIOMS preoperatively,which depends on histopathological examination.Intraoperative pathological examination is helpful to guiding the operation.The maximal resection of the tumors and involved bones is the key to prevention of PIOMS recurrence.

关 键 词：原发性溶骨性颅骨内脑膜瘤 诊断 治疗 

分 类 号：R739.45[医药卫生—肿瘤]