中枢神经系统血管外皮细胞瘤的诊断与治疗(附文献复习)  

Diagnosis and Treatment of Hemangiopericytomas in Central Nervous System

作　　者：蔡瑜[1] 成侃[1] 赵卫国[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院神经外科,200025

出　　处：《中国临床神经科学》2012年第6期648-652,共5页Chinese Journal of Clinical Neurosciences

摘　　要：目的:探讨中枢神经系统血管外皮细胞瘤(HPCs)的临床表现、影像学特征、鉴别诊断和治疗。方法:回顾性分析2001年1月至2010年9月收治的5例中枢神经系统HPCs患者的临床、影像学、病理学表现及治疗结果,并结合文献复习总结中枢神经系统HPCs的诊断和治疗经验。结果:5例HPCs患者中,2例术前确诊先行颈外动脉供血栓塞。5例均行显微神经外科手术下全切除肿瘤,术后辅助局部放射治疗。病理表现为典型的"鹿茸状"血管腔隙。免疫组化染色波形蛋白呈强阳性。3例随访未见肿瘤局部复发和转移,死亡1例,失访1例。结论:手术全切除肿瘤,并联合局部放疗是中枢神经系统HPCs的首选治疗方案。术前明确诊断、血管内栓塞减少肿瘤供血是影响手术成功的主要因素。HPCs具有局部复发率高、远期有颅外转移的特点,术后有必要长期随访观察。Aim： To elucidate the clinical manifestation, pathological features and the treatment of hemangiopericytoma （HPC） in central nervous system. Methods： 5 patients with intracranial HPC treated in our department from January 2001 to September 2009 were retrospectively reviewed. Results： Preoperative DSA imaging and tumor blood supply embolization were performed in 2 patients. Gross total removal （GTR） was achieved in all 5 patients, as well as postoperative adjuvant radiation therapy. Histological features were presented with thin-walled vascular networks showing a staghorn-like arrangement. All tumours were positive for vimentin. 3 patients were followed up, no local tumor recurrence and metastasis being presented. One patient died of heart attack. Conclusion： Preoperative differential diagnosis is important for the surgical treatment of HPC. Gross total removal combined with adjuvant radiation therapy is the optimal treatment in extending the recurrence-free intervals.

关 键 词：血管外皮细胞瘤 放射治疗 复发 转移 

分 类 号：R739.41[医药卫生—肿瘤]