脑实质内孤立性纤维性肿瘤1例  

Solitary fibrous tumor within the brain parenchyma:a case report

作　　者：熊海兵[1] 熊浩锋 霍建宏 曾实 XIONG Hai-bing;XIONG Hao-feng;HUO Jian-hong;ZENG Shi(Department of Neurosurgery,Ba'nan Hospital Affiliated to Chongqing Medical University,Chongqin 401320,China)

机构地区：[1]重庆医科大学附属巴南医院神经外科,重庆401320

出　　处：《中国临床神经外科杂志》2024年第11期702-704,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：孤立性纤维性肿瘤(SFT)是一种起源于CD34抗原的树突状间充质细胞的梭形细胞肿瘤,可发生在全身任何部位,以胸腹部多见,颅内少见。尽管SFT从病理学上被定义为间叶性非脑膜性肿瘤,但颅内SFT一般沿着脑膜生长,术前易误诊为脑膜瘤。脑实质内SFT临床罕见。本文报道1例左侧额叶SFT,为56岁男性,因头晕1个月、检查发现颅内占位1周入院,无明显神经系统阳性体征。头颅CT、MRI显示左侧额叶占位性病变。在全麻下,行左侧额叶病灶切除术。术中发现肿瘤位于左侧额叶白质内,质韧,边界清楚。术后病理检查显示SFT(WHO分级Ⅰ级)。术后3个月复查头颅MRI未见肿瘤复发。总之,脑实质内SFT罕见,大多良性生长,临床误诊率高,影像学检查有一定特异性,确诊主要靠病理诊断,手术全切除肿瘤是主要治疗方法,一般预后较好。Solitary fibrous tumor(SFT)is a spindle cell tumor originated from CD34-positive dendritic mesenchymal cells,which can occur in multiple parts of the body,most commonly in the thorax and abdomen,and is relatively rare in the brain.Although SFT is pathologically defined as a mesenchymal non-meningeal tumor,intracranial SFT usually grows along the meninges and is often misdiagnosed as meningioma before surgery.SFT within the brain parenchyma is even rarer.This paper reports a case of a 56-year-old male with a solitary fibrous tumor in the left frontal lobe.He was admitted to the hospital due to dizziness for one month and a space-occupying lesion in the brain was found one week ago.There were no obvious positive neurological signs.Head CT and MRI showed a space-occupying lesion in the left frontal lobe.Under general anesthesia,a left frontal lobe lesion resection was performed.During the operation,the tumor was found to be located in the white matter of the left frontal lobe,with a tough texture and clear boundaries.Postoperative pathological examination confirmed SFT(WHO grade I).Three months after the operation,a head MRI review showed no tumor recurrence.In conclusion,SFT within the brain parenchyma is extremely rare,mostly benign,with a high rate of clinical misdiagnosis.Imaging examinations have certain specificity,and the diagnosis depends on pathological examination.Surgical total resection is the main treatment method,and the prognosis is generally good.

关 键 词：脑内肿瘤 孤立性纤维性肿瘤 额叶 显微手术 

分 类 号：R739.41[医药卫生—肿瘤] R651.11[医药卫生—临床医学]