颅底软骨肉瘤的诊断和显微手术治疗:15例报告  

Microsurgical treatment and diagnosis of cranial base chondrosarcoma: report of 15 cases

作　　者：景治涛[1] 李龙[1] 杜绍楠[1] 刘佳[1] 王鑫[1] 李志鹏[1] 王明昊[1] 王运杰[1] 

机构地区：[1]中国医科大学第一附属医院神经外科,辽宁沈阳110001

出　　处：《中华神经外科疾病研究杂志》2015年第2期155-158,共4页Chinese Journal of Neurosurgical Disease Research

基　　金：国家自然科学基金资助项目(81101917);辽宁省教育厅基金资助项目(L2012273);辽宁省自然科学基金资助项目(2013021045)

摘　　要：目的总结颅底软骨肉瘤的临床特点,并探讨其治疗方法及预后。方法回顾10年间于中国医科大学附属第一医院神经外科进行显微手术治疗且病理证实为颅底软骨肉瘤的15例患者的临床资料,并对其进行细致分析。结果颅底软骨肉瘤的主要临床表现为头痛、恶心或颅神经受压症状。完全切除10例,近全切除4例,部分切除1例。11例病例诊断为高分化型软骨肉瘤,另4例为黏液型软骨肉瘤。术后9例患者进行放疗,1例进行伽马刀治疗。术后随访13例,复发3例,死亡1例。结论颅底软骨肉瘤的临床及影像学表现缺乏特异性,常与颅底重要血管神经关系密切,显微手术争取全切是治疗颅底软骨肉瘤的关键,术后辅助放疗是延缓其复发的常用手段。Objective The clinical features of the cranial base chondrosarcorm are summarized and the treatment and prognosis are discussed. Methods The clinical data of 15 patients with cranial base chondrosarcoma admitted to Department of Neurourgery of First Affiliated Hospital of China Medical University in last 10 years, who were performed microsurgery and confirmed by pathology diagnosis were reviewed and analyzed retrospectively. Results The main clinical manifestations were headache, nausea or cranial nerve compression symptoms. Total resection was in 10 cases, subtotal resection in 4 cases and partial resection in 1 case. Eleven cases were diagnosed as well-differentiated chondrosarcoma, and the other 4 cases were myxoid chondrosarcoma. Ten patients underwent post-operative radiotherapy. Follow-up results indicated 3 cases of recurrence and 1 dead case. Conclusion Cranial base chondrosarcoma is lack of the specific clinical manifestations and imaging features. Because of the close relationship between important nerves and vessels and tumor in cranial base, it is difficult to totally remove. The appropriate surgical approach for microsurgery is the key to total resection. Post-operative radiotherapy is significant important for the inhibition of the tumor recurrence.

关 键 词：颅底软骨肉瘤 临床表现 影像学表现 显微手术治疗 病理 预后 

分 类 号：R743.4[医药卫生—神经病学与精神病学]