颅内软骨肉瘤的临床特征和预后:附12例报告  

Clinical characteristics and prognosis of intracranial chondrosarcoma:a report of 12 cases

作　　者：杨凤东[1] 王一明 贾鑫 翟一轩 薛亚轲[1] 杜伟[1] 魏新亭[1] Yang Fengdong;Wang Yiming;Jia Xin;Zhai Yixuan;Xue Yake;Du Wei;Wei Xinting(Department of Neurosurgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院神经外科,郑州450000

出　　处：《中华神经外科杂志》2022年第9期900-905,共6页Chinese Journal of Neurosurgery

摘　　要：目的探讨颅内软骨肉瘤的临床特点和预后。方法回顾性分析郑州大学第一附属医院神经外科2011年4月至2019年9月收治的12例颅内软骨肉瘤(占同期收治颅内肿瘤患者的0.12%)的临床资料。病变位于鞍区海绵窦5例,中颅窝4例,岩斜区1例,颞枕部1例,顶枕部1例。术前仅5例诊断为软骨肉瘤。所有患者均行手术切除肿瘤,5例术后行辅助放疗,1例术后辅助化疗。随访方式为电话随访和门诊定期随访。采用Kaplan-Meier法分析患者的无进展生存期和总生存期,总结颅内软骨肉瘤的临床特点和预后。结果12例患者中,全切除7例,近全切除2例,部分切除3例。术后病理学结果显示,软骨肉瘤Ⅰ级6例,软骨肉瘤Ⅱ级3例,间叶型软骨肉瘤3例。12例患者的随访时间为13~123个月,2年无进展生存比例和总生存比例分别为7/12和11/12。随访期间5例患者复发,其中2例因疾病进展而死亡。3例间叶型软骨肉瘤均复发。结论颅内软骨肉瘤的发病率低,病变多位于颅底,误诊率高。治疗多采用手术切除及辅助放疗,其预后较好。Objective To explore the clinical characteristics and prognosis of intracranial chondrosarcoma.Methods A total of 12 cases of intracranial chondrosarcoma treated in the Department of Neurosurgery of the First Affiliated Hospital of Zhengzhou University from April 2011 to September 2019(accounting for 0.12%of patients with intracranial tumors admitted during the same period)were enrolled into this study and their data were retrospectively analyzed.The tumor was located in the cavernous sinus and sellar region in 5 cases,middle cranial fossa in 4 cases,petroclival region in 1 case,temporo-occipital region in 1 case,and parieto-occipital region in 1 case.Only 5 cases were diagnosed as chondrosarcoma preoperatively.All patients underwent tumor resection,and among them 5 underwent postoperative radiotherapy and 1 case received postoperative chemotherapy.Follow-up was performed by telephone and outpatient visits.Kaplan-Meier method was used to analyze the progression-free survival and overall survival of the patients.The clinical characteristics and prognosis of intracranial chondrosarcoma were summarized.Results Of the 12 patients,total resection were achieved in 7 cases,near-total resection in 2,and partial resection in 3.Pathological results revealed 6 cases of chondrosarcoma gradeⅠ,3 cases of chondrosarcoma gradeⅡ,3 cases of mesenchymal chondrosarcoma.The 2-year progression-free survival and overall survival ratios were 7/12 and 11/12 respectively.During the follow-up period of 13-123 months,5 patients had tumor recurrence and 2 patients died of recurrence.Tumor recurred in all 3 patients with mesenchymal chondrosarcoma.Conclusions Intracranial chondrosarcoma is a rare intracranial tumor with high misdiagnosis rate and mostly located at the skull base.Surgical resection and adjuvant radiotherapy are mostly used as the treatment,and the prognosis is relatively good.

关 键 词：脑肿瘤 软骨肉瘤 神经外科手术 疾病特征 预后 

分 类 号：R739.41[医药卫生—肿瘤]