哑铃型纵隔神经源性肿瘤的临床诊治分析  

Analysis on diagnosis and surgical treatment of dumbbell mediastinal neurogenic tumor

作　　者：杨增[1] 刘志东[2] 杨俊[3] 王德江[3] 高胜华[1] 

机构地区：[1]首都医科大学附属北京天坛医院胸外科 [2]首都医科大学附属北京胸科医院胸外科,北京101149 [3]首都医科大学附属北京天坛医院神经外科,北京100050

出　　处：《中国肿瘤临床与康复》2011年第3期265-268,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨哑铃型纵隔神经源性肿瘤的临床表现、诊断及外科治疗方法。方法回顾性分析6例哑铃型纵隔神经源性肿瘤的临床表现、影像学检查、病理学检查及治疗方法。结果患者临床症状主要有长期慢性胸背痛,多伴有双下肢的感觉和运动障碍,个别病例无症状。所有病例术前均行胸部MRI检查,结果与术中情况吻合。肿瘤均由胸外科医师与神经外科医师协作一期完全切除。术后胸背痛及感觉和运动障碍明显改善或消失,异常神经系统体征消失。恢复顺利,治愈出院。术后病理:神经鞘瘤4例,神经纤维瘤2例。结论胸部MRI对肿瘤的诊断及指导手术治疗具有重要价值。手术治疗应由胸外科医师与神经外科医师协作一期切除椎管内外肿瘤,先切除椎管内肿瘤,然后再切除椎旁胸内肿瘤,根据病变的位置、形态、大小采取不同的手术方式。Objective To investigate the clinical manifestations,diagnosis and surgical treatment of dumbbell mediastinal neurogenic tumor.Methods Retrospective analysis was made on 6 dumbbell mediastinal neurogenic tumor cases in terms of clinical manifestation,iconographic examination,pathologic examination and surgical treatment.Results Main clinical symptoms in patients were chronic thoracodorsal pain,usually accompanied with lower extremity sensory and motor disorders,individual cases were asymptomatic.All patients had undergone chest MRI before operation,the results coincided with the intraoperative conditions.Thoracic surgeons co-operated with neurosurgeons to complete tumour resection.Thoracodorsal pain and sensory and motor deficits improved or disappeared,abnormal neurological signs disappeared after operation.Patients recovered well and were cured.Pathology showed that there were 4 cases of Schwannoma and 2 cases of neurofibroma.Conclusion MRI is of great value in guiding surgical treatment and for the diagnosis of dumbbell mediastinal neurogenic tumor.The surgical treatment should be carried out by thoracic surgeons and neurosurgeons.The intraspinal tumors should be resected first and then the paravertebral intrathoracic tumors are resected at the same stage.The different surgical approaches may be taken according to location,shape and size of the tumor.

关 键 词：纵隔 哑铃型肿瘤 神经源性肿瘤 诊断 外科治疗 

分 类 号：R734.5[医药卫生—肿瘤] R730.4[医药卫生—临床医学]