Charabi S, Tos M, Thomsen J, Rygaard J, Fundova P, Charabi B
Department of Otorhinolaryngology, Head and Neck Surgery, Gentofte University Hospital, Hellerup, Denmark.
Acta Otolaryngol Suppl. 2000;543:11-3. doi: 10.1080/000164800453810-1.
The cystic variant of vestibular schwannoma (VS) presents a therapeutic dilemma. Several studies have previously demonstrated that the surgical outcome in this tumour entity is less favourable than that of solid tumours of comparable size. The "wait and scan" policy has not been recommended for these tumours, as the cystic elements expand, causing displacement of the brainstem and compression of the 4th ventricle, resulting in hydrocephalus. The large tumour size at diagnosis and the cystic contents do not support the role of radiosurgery as a therapeutic option. We have previously published the surgical outcome of 23 cystic VS. The present study includes 44 patients (44 cystic tumours) in a series of 773 tumours (5.7%) who underwent surgery in the period 1976 to 1996. This paper presents the neuroradiological and histological features of the tumours, as well as the results of tumour specimen implantation and surgery in athymic nude mice. Therapeutic options are also discussed.
前庭神经鞘瘤（VS）的囊性变体带来了治疗难题。此前有多项研究表明，在这一肿瘤类型中，手术结果不如大小相当的实性肿瘤。对于这些肿瘤，不推荐采用“观察与扫描”策略，因为囊状成分会扩大，导致脑干移位和第四脑室受压，进而引发脑积水。诊断时肿瘤体积较大以及囊内容物不支持将放射外科作为一种治疗选择。我们之前已发表了23例囊性VS的手术结果。本研究纳入了1976年至1996年期间接受手术的773例肿瘤患者中的44例（44个囊性肿瘤），占5.7%。本文呈现了肿瘤的神经放射学和组织学特征，以及肿瘤标本植入无胸腺裸鼠后的结果和手术情况。同时还讨论了治疗选择。
