Lapierre F, Bataille B, Vandermarcq P, Goujon J M, Wager M, Page P
Service de Neurochirurgie, CHU La Milétrie, Poitiers.
Neurochirurgie. 1999 Mar;45(1):29-38.
Large series of cauda equina tumors in adults are seldom reported. This study was based on the 231 cases collected in the French neurosurgery units for the congress of the Société Française de Neurochirurgie in October 1996. Schwannomas were the most frequent benign tumor in this series, followed by ependymomas. Very few malignant tumors were recorded, usually malignant neurinomas nearly always arising in patients with neurofibromatosis. Some other rare tumors were also observed including paragangliomas. This series confirms the contribution of pre-therapeutic neurological status to functional prognosis. All schwannomas can be cured while ependymomas and paragangliomas may recur after a very long delay. Surgery must be as complete as possible since adjuvant therapies have proven to have little efficacy. This type of tumor requires a very long follow-up. Prognosis is good for hemangioblastoma. When present, abnormal sphincter function is an argument for poor prognosis. It may appear after primary surgery or more often after treatment of recurrence.
关于成人大马尾神经肿瘤的大型病例系列报道很少。本研究基于1996年10月法国神经外科学会大会上法国各神经外科单位收集的231例病例。在该病例系列中，神经鞘瘤是最常见的良性肿瘤，其次是室管膜瘤。记录到的恶性肿瘤非常少，通常是恶性神经鞘瘤，几乎总是发生在神经纤维瘤病患者中。还观察到一些其他罕见肿瘤，包括副神经节瘤。该病例系列证实了治疗前神经学状态对功能预后的影响。所有神经鞘瘤都可以治愈，而室管膜瘤和副神经节瘤可能在很长一段时间后复发。手术必须尽可能彻底，因为辅助治疗已证明疗效甚微。这类肿瘤需要非常长期的随访。成血管细胞瘤的预后良好。存在异常括约肌功能是预后不良的一个依据。它可能在初次手术后出现，或更常见于复发治疗后出现。
