颅盖骨孤立性浆细胞瘤一例并文献复习  

Solitary Plasmacytoma of the Calvarium: A Case Report and Literature Review

作　　者：焦风[1] 刘波[1] 梁冶矢[1] 

机构地区：[1]北京大学人民医院神经外科,北京市100044

出　　处：《中国全科医学》2014年第24期2895-2896,2900,共3页Chinese General Practice

摘　　要：颅脑部位的孤立性浆细胞瘤只占髓外孤立性浆细胞瘤的极少部分,而颅盖骨的孤立性浆细胞瘤则更为罕见。本文分析了我院2010-11-18收治的1例颅盖骨孤立性浆细胞瘤患者的临床表现及治疗经过,并回顾相关文献对颅盖骨孤立性浆细胞瘤的临床特征及预后进行分析。本例患者为中年男性,主诉"枕部无痛性进行性增大肿物6个月"。CT及MRI检查提示枕骨溶骨性占位,硬膜及脑组织无受累。患者接受了病变切除加颅骨修补手术治疗,术后病理学证实为浆细胞瘤,全面检查未见全身性骨髓瘤的证据。患者术后未进行放化疗,随访24个月肿瘤无局部复发但进展为多发性骨髓瘤。检索以往文献,共检索到54例有关颅盖骨孤立性浆细胞瘤的报道,其中52例(96.3%)患者进行了手术或手术+放疗,10例(18.5%)患者转变为多发性骨髓瘤。研究结果提示颅盖骨孤立性浆细胞瘤通常预后良好,但少数病例常在疾病的某个阶段转变为多发性骨髓瘤而致病情恶化。目前推荐的治疗方案为根治性手术切除加放疗。Solitary craniocerebral location is the least frequent of all extramedullary solitary plasmacytomas. Solitary plasmacytoma of the calvarium is even more rare. We retrospectively analyzed the clinical manifestation and prognosis of a male pa-tient presented with solitary plasmacytoma of the calvarium and reviewed the current related literatures. This is a middle-aged male patient whose history was painless tumor of occipital location for 6 months. Computed tomography （ CT）and magnetic reso-nance image（ MRI）showed occipital mass with bony destruction,but the dura and brain were not involved. The patient accepted spread surgical resection and cranioplasty. Histological examination confirmed plasmacytoma. Postoperative myeloma work-up was done,the results were normal. Bone marrow aspiration showed no evidence of systemic myeloma. The patient did not receive the radiotherapy or chemotherapy. After 24 months followed-up,the tumor showed no local recurrence but unfortunately progressed to multiple myeloma. Totally 54 cases were reviewed of solitary plasmacytoma of the calvarium. 52 patients（96. 3%）were treated with surgery or together with radiotherapy,but only 10 patients（18. 5%）transformed to multiple myeloma. Our study showed that solitary calvarial plasmacytomas have generally good prognosis,whereas several patients invariably progress to multiple mye-loma at some stage. Radical surgery followed by radiation is the best treatment option available at present.

关 键 词：颅骨 浆细胞瘤 颅骨肿瘤 多发性骨髓瘤 

分 类 号：R651.1[医药卫生—外科学]