Lyons M K, Kelly P J
Department of Neurological Surgery, Mayo Clinic, Rochester, Minn.
Stereotact Funct Neurosurg. 1992;59(1-4):100-4. doi: 10.1159/000098924.
Twenty-three cases of pathologically verified thalamic pilocytic astrocytomas diagnosed at computer-assisted stereotactic biopsy and/or volumetric resection at the Mayo Clinic between January 1985 and October 1990 were reviewed. Computer-assisted stereotactic volumetric resection was performed in 19 patients. Postoperative imaging demonstrated no residual contrast-enhancing tumor in 14 patients and a small amount of contrast-enhancing tumor (less than 5% of the original tumor volume) in 5 patients. Biopsy only was performed in 4 patients: 2 with primarily cystic tumors successfully treated with stereotactic instillation of 32P, and 2 patients with stable (nonprogressive) deficits. There was 1 operative death; a patient with tumor extending into the midbrain became comatose and died 10 days after surgery. The remaining 22 patients are alive and well. Computer-assisted stereotactic volumetric resection of thalamic pilocytic astrocytomas can be performed with low morbidity and a favorable long-term prognosis.
回顾了1985年1月至1990年10月间在梅奥诊所经计算机辅助立体定向活检和/或体积切除术病理确诊的23例丘脑毛细胞型星形细胞瘤病例。19例患者接受了计算机辅助立体定向体积切除术。术后影像学检查显示，14例患者无残留强化肿瘤，5例患者有少量强化肿瘤（小于原始肿瘤体积的5%）。仅4例患者接受了活检：2例主要为囊性肿瘤的患者通过立体定向注入32P成功治疗，2例患者有稳定（非进行性）神经功能缺损。有1例手术死亡；1例肿瘤延伸至中脑的患者术后10天昏迷并死亡。其余22例患者存活且情况良好。计算机辅助立体定向体积切除术治疗丘脑毛细胞型星形细胞瘤的发病率低，长期预后良好。
