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接受干扰素治疗的多发性硬化症患者脑膜瘤的生长动力学:两例报告。

Growth dynamics of meningiomas in patients with multiple sclerosis treated with interferon: report of two cases.

作者信息

Batay F, Al-Mefty O

机构信息

Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.

出版信息

Acta Neurochir (Wien). 2002 Apr;144(4):365-8. doi: 10.1007/s007010200050.

Abstract

BACKGROUND

Although multiple sclerosis (MS) is a common disease of the central nervous system, the association of intraparenchymal tumour has been rarely reported and the potential relationship between intracranial meningioma and MS has not been seriously analysed. This report addresses the association of multiple sclerosis and intracranial meningioma and discusses the effect of interferon treatment on tumour progression.

CLINICAL PRESENTATION

We report two cases with multiple sclerosis, who developed meningioma four and twenty years after the diagnosis of MS was made. Neither patient had a history of meningioma initially and both were being treated interferon when the meningioma was progressed.

FINDINGS

Histological examination of two cases revealed meningothelial meningioma. The first patient's KI67 level was 2.5% and was positive for the progesterone and estrogen receptor. Chromosomal analysis showed some abnormalities. In the second case, mild atypical change by presence of nuclear enlargement and rare mitotic figures were noted and PCNA, KI67 levels were less than 2%.

CONCLUSIONS

We reported the association of multiple sclerosis and intracranial meningioma and observed the progression of the meningiomas during interferon treatment. Although, we cannot exclude the coincidence between the two diseases we discussed suspicious relationship between the interferon treatment and the tumour progression.

摘要

背景

尽管多发性硬化症(MS)是中枢神经系统的常见疾病,但实质内肿瘤的关联鲜有报道,且颅内脑膜瘤与MS之间的潜在关系尚未得到认真分析。本报告阐述了多发性硬化症与颅内脑膜瘤的关联,并探讨了干扰素治疗对肿瘤进展的影响。

临床表现

我们报告了2例多发性硬化症患者,他们在MS诊断后4年和20年分别发生了脑膜瘤。最初两名患者均无脑膜瘤病史,且在脑膜瘤进展时均接受干扰素治疗。

研究结果

两例患者的组织学检查均显示为脑膜内皮型脑膜瘤。首例患者的Ki-67水平为2.5%,孕激素和雌激素受体呈阳性。染色体分析显示存在一些异常。第二例患者可见细胞核增大和罕见的有丝分裂象,提示轻度非典型改变,增殖细胞核抗原(PCNA)和Ki-67水平均低于2%。

结论

我们报告了多发性硬化症与颅内脑膜瘤的关联,并观察到干扰素治疗期间脑膜瘤的进展。虽然我们不能排除两种疾病的巧合,但我们讨论了干扰素治疗与肿瘤进展之间的可疑关系。

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