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马尾神经肿瘤:一项对231例成人病例的法国多中心回顾性研究及文献综述

Cauda equina tumors: a French multicenter retrospective review of 231 adult cases and review of the literature.

作者信息

Wager M, Lapierre F, Blanc J L, Listrat A, Bataille B

机构信息

Service de Neurochirurgie, C.H.U., La Milétrie, Poitiers, France.

出版信息

Neurosurg Rev. 2000 Sep;23(3):119-29; discussion 130-1. doi: 10.1007/pl00011940.

Abstract

Large series of cauda equina tumors in adults are seldom reported. This French series retrospectively reviews 231 cases collected for the congress of the Societe Francaise de Neurochirurgie in 1996. The authors first analyze this series and then discuss the pertinent literature. Schwannoma was the most frequent benign tumor in this series, followed by ependymoma. Very few malignant tumors were recorded; these were usually malignant neurinomas nearly always in neurofibromatosis patients. Some other rare tumors were also recorded, including paragangliomas. This series confirms the importance of the pretherapeutic neurological status in 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 are proven to have little efficacy. This type of tumor requires very long follow-up. Prognosis is good for hemangioblastomas. Sphincter dysfunctions carries a poor prognosis and may appear after primary surgery, more often after treatment of recurrences.

摘要

很少有关于成人大马尾神经肿瘤的大型系列报道。这个法国的系列研究回顾性分析了1996年法国神经外科学会大会收集的231例病例。作者首先分析了这个系列病例,然后讨论了相关文献。在这个系列中,神经鞘瘤是最常见的良性肿瘤,其次是室管膜瘤。记录的恶性肿瘤很少;这些通常是恶性神经鞘瘤,几乎总是见于神经纤维瘤病患者。还记录了一些其他罕见肿瘤,包括副神经节瘤。这个系列证实了治疗前神经状态对功能预后的重要性。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时间后复发。手术必须尽可能彻底,因为辅助治疗已被证明疗效甚微。这类肿瘤需要非常长期的随访。成血管细胞瘤的预后良好。括约肌功能障碍预后较差,可能在初次手术后出现,更常见于复发治疗后。

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