头部原发性硬膜外脑膜瘤的临床特点  

Clinical characteristics of primary extradural meningiomas in head

作　　者：刘玉光[1] 张泽立[1] 王宏伟[1] 

机构地区：[1]山东大学齐鲁医院神经外科,山东大学脑科学研究所,济南250012

出　　处：《中华医学杂志》2014年第9期692-694,共3页National Medical Journal of China

摘　　要：目的 研究头部原发性硬膜外脑膜瘤（PEM）的临床特点、治疗效果及预后情况.方法 针对山东大学齐鲁医院1994年5月至2012年12月收治19例头部PEM的年龄、性别、症状学、肿瘤位置、分型、影像学特点、手术结果、病理结果及随访资料进行了回顾性分析.结果 本组头部PEM占全部脑膜瘤的1.2%,男女比例1：0.7,平均年龄36.6岁,有两个高发年龄段;鼻塞及病变区无痛性逐渐生长的包块是常见的症状,平均病程3.07年;颅穹窿、副鼻窦腔、眶内与硬膜外腔是常见的发病部位;Ⅱ型最常见;肿瘤全切率100%,无围手术期死亡;良性与非典型性脑膜瘤分别占94.7%和6.3%;常见的组织亚型是上皮型和砂粒型.经0.25~8.5 年（平均2.43年）随访,复发1例,无死亡.结论 与原发性硬膜内脑膜瘤相比,头部PEM具有明显的临床特点;全部切除肿瘤及受累结构并组织缺损重建是最佳手术治疗方案;绝大多数肿瘤在全切除后预后良好.Objective To explore the clinical characteristics, efficacy and prognosis of primary extradural meningiomas （PEMs） in head. Methods A total of 19 treated surgically case of PEMs at Qilu Hospital, Shandong University between May 1994 and December 2012 were analyzed retrospectively with respects to their demographic features, presenting symptoms ＆amp; duration, tumor location ＆amp; type, imaging features, surgical results, pathological grade, histological subtype and follow-up outcomes. Results PEMs in head accounted for 1.2% of all meningiomas in this group. The male-to-female ratio was 1∶ 0.7. The mean age was 36.6 years with a bimodal distribution of age. The common presenting symptoms included nasal obstruction and a painless and gradually expanding mass in the region of lesion. The average duration of symptom was 3.07 years. The skull convexities, paranasal sinuse and nasal cavity, orbit and epidural space were common tumor sites. The most common type was typeⅡ. The rate of total tumor removal was 100%. And no perioperative mortality occurred in this series. Benign and atypical meningiomas accounted for 94.7% and 6.3% respectively. Meningothelial and psammomatous meningiomas were common histopathological subtypes. There was one case of tumoral recurrence. And no mortality was reported during a mean follow-up period of 2.43 （0.25-8.5） years. Conclusion PEMs in head have some marked clinical characteristics compared with primary intradural meningiomas. Total tumor removal together with a wide excision of all involved tissue followed by the reconstruction of tissue defects is the best surgical option. The prognosis is excellent in most cases after complete resection.

关 键 词：原发性硬膜外脑膜瘤 异位脑膜瘤 颅骨内脑膜瘤 临床特点 治疗 

分 类 号：R739.45[医药卫生—肿瘤]