Akai Takuya, Shiraga Shunsuke, Iizuka Hideaki, Kishibe Miyuki, Kawakami Shigehiko, Ueda Yoshimichi
Department of Neurosurgery, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan.
Neurol Med Chir (Tokyo). 2004 Nov;44(11):600-2. doi: 10.2176/nmc.44.600.
A 70-year-old woman presented with meningioma with metastasis to the skin incision. Neuroimaging demonstrated a tumor of the falx extending to the frontal bone. The tumor was grossly totally resected through a coronal skin incision. The histological diagnosis was meningotheliomatous meningioma. The tumor recurred in the ethmoid sinus 2 years later, and was resected through the transfacial approach. One year later, the tumor recurred in the ethmoid sinus and orbit, and was resected through the transcranial approach. Six months later, she noticed an isolated small mass under the skin incision, distant from a further recurrence of the tumor. Both tumors were resected. The histological diagnosis was atypical meningioma. Resection of atypical meningioma carries the risk of iatrogenic metastasis. Surgeons should wash out the operative field carefully and change surgical tools frequently.
一名70岁女性因脑膜瘤伴皮肤切口转移就诊。神经影像学检查显示镰旁肿瘤延伸至额骨。通过冠状皮肤切口将肿瘤大体完全切除。组织学诊断为脑膜皮型脑膜瘤。2年后肿瘤在筛窦复发,通过经面部入路切除。1年后,肿瘤在筛窦和眼眶复发,通过经颅入路切除。6个月后,她在皮肤切口下方发现一个孤立的小肿块,与肿瘤的再次复发部位相距较远。两个肿瘤均被切除。组织学诊断为非典型脑膜瘤。切除非典型脑膜瘤存在医源性转移的风险。外科医生应仔细冲洗手术区域并频繁更换手术工具。