Fountas K N, Kapsalaki E, Kassam M, Feltes C H, Dimopoulos V G, Robinson J S, Smith J R
Department of Neurosurgery, Medical Center of Central Georgia, Mercer University, School of Medicine, Macon, 31201-2155, USA.
Neurosurg Rev. 2006 Apr;29(2):145-53. doi: 10.1007/s10143-005-0001-9. Epub 2006 Jan 4.
Hemangiopericytomas represent rare intracranial tumors that have a tendency to recur locally and have the unique characteristic of giving extracranial metastases. Our current communication reviews a series of patients diagnosed with hemangiopericytoma who were treated in our facility. Eleven patients with a mean age of 51.2 years underwent follow-up for a mean time of 7.1 years. Their neuroimaging preoperative evaluation included plain skull X-rays, head CT scans, brain MRI, angiograms, and (1)HMRS. Preoperative embolization of the tumor was employed in 6/11 patients. All patients underwent craniotomy for tumor resection and postoperative radiation treatment was employed on all but one. Grade I resection was accomplished in 6/11 (54.5%), grade III in 4/11 (36.4%), and grade IV in 1/11 (9.1%). Local recurrence was detected in 3/11 (27.3%) at a mean period of 5 (range 2-7.5) years. Extracranial metastatic disease was documented in 4/11 (36.4%) patients at a mean of 4.9 (range 2.5-7) years after the initial diagnosis. The GOS score was: 7/11 (63.6%) scored 5, while 4/11 (36.4%) died at a mean time of 5.5 (range 3-8) years after the initial diagnosis. Intracranial hemangiopericytomas management requires aggressive surgical resection, postoperative radiation treatment, and extensive follow-up to rule out local recurrences and delayed extracranial metastases.
血管外皮细胞瘤是一种罕见的颅内肿瘤,有局部复发的倾向,并具有发生颅外转移的独特特征。我们目前的交流回顾了一系列在我们机构接受治疗的被诊断为血管外皮细胞瘤的患者。11名平均年龄为51.2岁的患者接受了平均7.1年的随访。他们术前的神经影像学评估包括头颅X线平片、头部CT扫描、脑部MRI、血管造影以及(1)氢质子磁共振波谱分析。11名患者中有6名在术前进行了肿瘤栓塞。所有患者均接受了开颅肿瘤切除术,除1名患者外,其余患者均接受了术后放疗。11名患者中有6名(54.5%)实现了Ⅰ级切除,4名(36.4%)为Ⅲ级切除,1名(9.1%)为Ⅳ级切除。11名患者中有3名(27.3%)在平均5年(范围2 - 7.5年)时出现局部复发。4名(36.4%)患者在初次诊断后平均4.9年(范围2.5 - 7年)记录到颅外转移疾病。格拉斯哥预后评分(GOS)为:11名患者中有7名(63.6%)评分为5分,而4名(36.4%)在初次诊断后平均5.5年(范围3 - 8年)死亡。颅内血管外皮细胞瘤的治疗需要积极的手术切除、术后放疗以及广泛的随访,以排除局部复发和延迟的颅外转移。