颅骨巨细胞瘤的诊断和综合治疗  

Diagnosis and comprehensive treatment of giant cell tumor of skull

作　　者：张振宇[1] 徐健[1] 程海霞[1] 陈旦麒[1] 钟平[1] 

机构地区：[1]上海,复旦大学附属华山医院神经外科,上海200040

出　　处：《中华神经外科杂志》2013年第12期1245-1248,共4页Chinese Journal of Neurosurgery

摘　　要：目的探讨颅骨巨细胞瘤的诊断和综合治疗。方法回顾性总结1995年4月至2011年12月收治的16例经病理证实的颅骨巨细胞瘤，并结合文献对本病的特点和治疗方法进行分析。结果16例患者中肿瘤位于蝶骨8例、颞骨7例、枕骨1例。临床表现主要有头痛、脑神经受累症状等。全切除6例，未全切除10例。共随访到14例，平均随访30．75个月，其中1例因肿瘤复发而死亡；3例肿瘤复发，10例无明显复发。结论颅骨巨细胞瘤临床十分罕见，其症状与肿瘤的发生部位密切相关。手术切除是主要的治疗方法，应力求完全切除。对于未能全切的病例，术后放疗的效果肯定且不良反应罕见。目前较少应用化疔，其方案和疗效有待于进一步研究。Objective To explore the diagnosis and comprehensive treatment strategies for giant cell tumor（GCT） of skull. Methods The investigators summarized 16 cases with GCT of skull between April 1995 and December 2011, and analyzed the clinical features, radiological manifestations, pathological features and comprehensive treatment strategies of GCT of skull in combination with reviewing relevant literatures. Results Among the 16 eases, 8 tumors were located in sphenoid bone, 7 were located in temporal bone and 1 in occipital bone. Presenting symptoms mainly included headache, symptoms of cranial nerves involvements and others. 6 tumors were completely removed and 10 tumors were incompletely removed. The follow - up data of 14 patients were collected with a mean follow - up duration of 30. 75 months. Among these patients, 1 patient had died due to tumor recurrence, 3 patients were alive with tumor recurrence and 10 patients had normal postoperative life without tumor recurrence. Conclusions GCT of skull is clinically rare and its presenting symptoms are closely related to its location. Surgery is the principal treatment strategy and the tumor should be removed as complete as possible. As for those patients with incomplete tumor resection, postoperative radiation has positive efficacy with little side effect. Chemotherapy is rarely used and should be further studied in the future.

关 键 词：颅骨 骨巨细胞瘤 诊断 综合治疗 

分 类 号：R739.4[医药卫生—肿瘤]