侵犯颅骨并完全钙化性脑膜瘤的诊断及治疗  

Diagnosis and treatment of completely calcified meningiomas with the invasion of skull

作　　者：李贞伟[1] 于明圣[2] 李冰[1] 王红光[1] 孙梅[1] 黄楹[1] 

机构地区：[1]天津市环湖医院神经外科,300060 [2]天津医科大学研究生院,300070

出　　处：《中国微侵袭神经外科杂志》2016年第4期151-153,共3页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的探讨侵犯颅骨并完全钙化性脑膜瘤的临床特点、治疗方法及预后。方法回顾性分析8例经手术治疗的脑膜瘤病人的临床资料。术中见肿瘤完全钙化,质地较韧,严重侵犯颅骨。结果手术切除Simpson分级：Ⅰ～Ⅱ级7例,Ⅲ级1例。术后病理：脑膜瘤（纤维型4例、过渡型2例、砂粒体型2例）。术后症状均有不同程度改善,无并发症发生。随访8例,时间3～84个月,7例SimpsonⅠ～Ⅱ级切除的病人均未见肿瘤复发,1例SimpsonⅢ级切除的病人于术后24个月复查MRI时见肿瘤体积较前变大,密切随访。结论侵犯颅骨的完全钙化性脑膜瘤较为少见,头部CT脑窗及骨窗上有较为特异性的表现,恰当的手术方案可获得良好的治疗效果,术后定期影像学随访对于预防肿瘤复发尤为重要。Objective To investigate the clinical characteristics, treatment and prognosis of completely calcified meningiomas with invasion of the skull. Methods Clinical data of 8 such patients who received surgery resection were analyzed retrospectively. It was found that during the surgery the tumors were completely calcified, the texture was flexible, and the skull was seriously invaded. Results The tumor resection of Simpson grade Ⅰ to Ⅱ was achieved in 7 patients and grade Ⅲ in 1. Postoperative pathological diagnosis was meningioma including fibrous in 4 patients, transiens in 2 and psammomatous in 2. The symptoms were improved to different degrees and no complication occurred after surgery. All the patients were followed up for 3 to 84 months, no relapse occurred in 7 patients with Simpson grade Ⅰ to Ⅱ resection. For the patient with Simpson grade Ⅲ resection, the tumor was larger in size by MRI 24 months after surgery than that before surgery and close follow-up was recommended. Conclusions The completely calcified meningioma with invasion of the skull is relatively rare and there are characteristic performances in head CT brain window and bone window. A proper therapy can obtain good outcome and postoperative regular radiographic follow-up is particularly important to prevent tumor recurrence.

关 键 词：脑膜瘤 钙化 侵犯颅骨 显微外科手术 

分 类 号：R739.45[医药卫生—肿瘤]