脊髓室管膜下瘤8例临床分析  

Clinical features and treatments of spinal subependymoma:eight cases report

作　　者：李颉[1] 曹恒聪[1] 刘英[1] 曹秦辉[1] 部一[1] 李国华[1] 谷守山[1] 

机构地区：[1]唐山市第二医院脊柱一科,063000

出　　处：《疑难病杂志》2016年第8期857-859,共3页Chinese Journal of Difficult and Complicated Cases

基　　金：2015年唐山市科技计划项目(15130221a)

摘　　要：目的探讨脊髓室管膜下瘤的临床特征与治疗方法。方法回顾性分析2000年1月—2015年3月唐山市第二医院脊柱一科收治的8例脊髓室管膜下瘤患者临床资料,根据患者临床表现、影像学检查、疗效及随访结果,探讨脊髓室管膜下瘤临床特征及理想治疗方案。结果 8例脊髓室管膜瘤患者均以四肢麻木无力起病。颈部为多发节段,8例患者中肿瘤位于颈段4例,位于颈胸段4例;位于髓内6例,位于髓外2例。MR检查示大多数瘤体呈偏心性生长,脊髓左侧3例,右侧4例,中心部位1例;T1加权像瘤体呈低信号5例,呈等信号3例;T2加权像8例瘤体均呈高信号,强化MR瘤体未见明显增强。4例患者行完全切除术后症状消失;4例患者行次全切除术后肢体麻木程度减轻;1例因复发行二次手术之后未再复发。全部患者均存活。结论脊髓室管膜下瘤无特异性临床表现,术前MR可为诊断提供依据。手术作为常规治疗方法,完全切除效果优于次全切除,不建议行术后放疗。对于复发患者可以再次行手术切除治疗。Objective To investigate the clinical features and treatments of spinal subependymoma （ SSE） .Methods From January 2000 to March 2015, 8 cases of spinal subependymomain Second Hospital of Tangshan were retrospectively studied.Total surgical removal was achieved in four patients and subtotal one was done in the other four patients.No patient had postoperative radiotherapy.Tumor recurrence was seen in one patient who had subtotal resection and the patient received subtotal removal again.Clinical presentations, imageological exams, therapeutic outcomes and follow up of eight patientswere studied to get clinical features and best therapy.Results The onsets of SSE were numbness and weakness of limbs.MRI find-ings showed that most of the masses were eccentrically located within the spinal cord.On T1 weighted image, the masses were hypo-intense （ n =5） or isointense （ n =3） to the spinal cord.On T2 weighted image, all the masses were homogeneously hyper-intense.In Gadolinium contrast, no obvious enhancement was seen in all cases.After operation, four total removal pa-tients were asymptomatic and four subtotal removal patients had limb numbness relieved.The patient who had tumor recurrence received subtotal removal again and no more recurrence appeared.There was no relevant factor with tumor recurrence.No pa-tient deceased in this series.Conclusion The clinical feature of SSE is largely nonspecific.MRI scan conduces to preopera-tive diagnosis.Surgery is the routine treatment and total removal seems to have better outcomes than subtotal removal.In the recurrence patient, operation is still the therapeutic choice.Postoperative radiotherapy might not be necessary for incompletely resected tumor.

关 键 词：室管膜下瘤 脊髓 临床特征 诊断 治疗 

分 类 号：R739.4[医药卫生—肿瘤]