原发性椎管内副神经节瘤的诊断和治疗  

Diagnosis and treatment of primary intraspinal paraganglioma

作　　者：胡少荣 彭鹏[1] 陈锋[1] 王襄阳 徐梦奇 李婧文 Hu Shaorong;Peng Peng;Chen Feng;Wang Xiangyang;Xu Mengqi;Li Jingwen(Department of Neurosurgery,Xiangyang Central Hospital,Xiangyang 441000,China;Department of Oncology,Xiangyang Central Hospital,Xiangyang 441000,China)

机构地区：[1]襄阳市中心医院神经外科,襄阳441000 [2]襄阳市中心医院肿瘤科,襄阳441000

出　　处：《中国医师进修杂志》2023年第9期844-849,共6页Chinese Journal of Postgraduates of Medicine

基　　金：湖北省卫生健康2023-2024年度面上项目(WJ2023M159)。

摘　　要：目的:分析原发性椎管内副神经节瘤的临床表现、影像学特点及手术疗效,为副神经节瘤的诊断和治疗提供依据。方法:回顾性分析襄阳市中心医院2014年4月至2021年1月6例原发性椎管内副神经节瘤患者的临床资料,均采用后正中入路行显微手术治疗。结果:6例患者均实现肿瘤全切,术后病理诊断为副神经节瘤。其中,1例肿瘤位于颈段椎管内外,无椎体破坏;1例肿瘤位于腰骶段椎管内,同时伴有椎体破坏;其余4例均位于腰段椎管内。术后随访12~120个月,中位随访时间61.5个月,末次随访行MRI检查,均未复发。结论:原发性椎管内副神经节瘤临床罕见,大多为无功能性良性肿瘤,临床和影像学表现缺乏特异性,术前常难以诊断。手术切除,特别是完整切除预后较好,辅助治疗效果不确定。Objective To provide a basis for its diagnosis and treatment for clinicians by analyzing the clinical manifestations,imaging features and surgical efficacy of primary intraspinal paraganglioma.Methods The clinical data of 6 patients with intraspinal paraganglioma from April 2014 to January 2021 in Xiangyang Central Hospital were retrospectively analyzed,and all patients were treated with microsurgery via a posterior median approach.Results All 6 patients achieved total tumor resection,and the postoperative pathological diagnosis was paraganglioma,Among them,1 patient's tumor located inside and outside the cervical spinal canal without destruction of the vertebral body;1 patient's tumor located lumbosacral canal with destruction of the vertebral body;the others 4 patients'tumor located within the lumbar spinal canal.The patients were followed up for 12 to 120 months after surgery,with a median follow-up time of 61.5 months.MRI examination was performed at the last followup,and no recurrence was observed.The patients underwent MRI examination at the last follow-up,and none of the patients recurred.ConclusionsTThe intraspinal paraganglioma is a rare tumor,and nonfunctional benign tumors are predominant.Its clinical and imaging manifestations lack specificity and are often difficult to diagnose before surgery.Surgical resection,especially complete resection,has a better prognosis,and the effectiveness of adjuvant therapy is uncertain.

关 键 词：椎管 副神经节瘤 诊断 显微外科手术 

分 类 号：R739.42[医药卫生—肿瘤]