儿童脑膜瘤18例并文献复习  

Pediatric meningioma:a report of 18 cases with a literature review

作　　者：刘冬[1] 吉文玉[1] 图柯拜·吐尔托合提 赵俊红 杨茜涵 玛合江·阿哈力别克 凯赛·吐尔逊 汪永新[1] Liu Dong;Ji Wenyu;Tukebai·Tuertuoheti;Zhao Junhong;Yang Qianhan;Mahejiang·Ahalibieke;Kaisai·Tuerxun;Wang Yongxin(Department of Pediatric Neurosurgery,First Affiliated Hospital,Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院小儿神经外科,乌鲁木齐830054

出　　处：《中华小儿外科杂志》2024年第7期587-593,共7页Chinese Journal of Pediatric Surgery

基　　金：上海合作组织科技伙伴计划及国际科技合作计划(2021E01013)。

摘　　要：目的探讨儿童脑膜瘤的临床特点和诊疗方式。方法回顾性分析2011年1月至2021年9月新疆医科大学第一附属医院收治的18例脑膜瘤患儿临床资料,其中男9例,女9例;患儿的中位年龄为11.5岁,范围在4~17岁。8例患儿首发症状为头痛呕吐,5例癫痫,3例偏瘫,1例步态不稳,另有1例为体检时发现。2例患儿入院前明确合并神经纤维瘤病,其余患儿无特殊既往史。总结18例患儿的术前诊断、影像学表现、肿瘤部位及切除程度、手术情况、组织学病理结果。以"脑膜瘤"及其英文"meningiomas""meningeal tumors"为关键词,检索于2000年1月至2022年6月发表并收录于万方、中国知网、维普、中国生物医学文献服务系统、PubMed、Google Scholar等数据库的相关文献,并行文献复习。结果本组18例患儿中术前17例行头颅磁共振检查,除6例误诊为其他肿瘤外,其余患儿诊断为脑膜瘤;肿瘤位于幕上15例,幕下3例。18例患儿中16例接受开颅手术,手术均顺利完成;手术全切11例,次全切除4例,部分切除1例。16例患儿术后肿瘤病理显示均为脑膜瘤,其中WHO分级Ⅰ级8例,Ⅱ级6例,Ⅲ级2例。术后15例接受随访6~126个月,1例复发,1例死亡,其余无肿瘤进展。最终检索到9篇符合标准的文献,结合本组18例患儿,共345例患儿,其中男189例,女性156;合并神经纤维瘤病38例;肿瘤位于幕上228例,幕下67例,其他部位50例;肿瘤全切率为59.7%(206/345),其中WHO分级Ⅰ级、Ⅱ级、Ⅲ级分别占比为72.1%(248/344)、20.9%(72/344)、7.0%(24/344),肿瘤复发率为29.0%(75/259),死亡率为8.9%(23/259)。结论脑膜瘤是一种罕见的儿童中枢神经系统肿瘤,与成人相比,其临床特征、影像学表现、病理特点等有所不同且多变,WHO分级Ⅱ级、Ⅲ级肿瘤占比高,手术是治疗的主要手段。Objective To explore the clinical characteristics and treatments of meningiomas in children.Methods From January 2011 to September 2021,18 children with meningiomas were retrospectively examined with a literature review.From January 2000 to June 2022,the relevant literatures were retrieved from the databases of Wanfang,China National Knowledge Infrastructure(CNKI),VIP,Chinese Biomedical Literature Service System,PubMed and Google Scholar with the keywords of"meningiomas"and"meningeal tumors".Results Among 18 children in this group,17 were examined preoperatively by cranial magnetic resonance imaging(MRI).Six children were misdiagnosed as other tumors.Tumors were located supratentorially(n=15)and infratentorially(n=3).Craniotomy was successfully completed(n=16),including total resection(n=11),subtotal resection(n=4)and partial resection(n=1).Postoperative tumor pathology confirmed meningioma of WHO gradeⅠ(n=8),gradeⅡ(n=6)and gradeⅢ(n=2).Fifteen patients were followed up for(6-126)months.There were recurrence(n=1),death(n=1)and tumor non-progression(n=13).Finally 9 eligible items were retrieved.Along with 18 children in this group,a total of 345 children were analyzed.There were 189 boys and 156 girls.There was a concurrence of neurofibromatosis(n=38).Tumors were supratentorial(n=228),infratentorial(n=67)and others(n=50).Total tumor resection rate was 59.7%.WHO gradeⅠ,ⅡandⅢaccounted for 72.1%,21.0%and 7.0%.Tumor recurrence rate was 29.0%and mortality rate 8.9%.Conclusions Meningioma is a rare tumor of central nervous system in children.Its clinical characteristics,imaging manifestations and pathological characteristics differ greatly from those of adults.The proportion of WHOⅡ/Ⅲtumors is higher than that of adults.Surgery is a major treatment of pediatric meningioma.

关 键 词：脑膜瘤 症状 儿童 

分 类 号：R739.45[医药卫生—肿瘤]