Dafford Kurtus, Kim Daniel, Reid Natasha, Kline David
Department of Neurosurgery, Tulane University Medical Center, New Orleans, Louisiana, USA.
Neurosurg Focus. 2007 Jun 15;22(6):E10.
Pelvic plexus tumors are unusual entities. These lesions often reach significant size prior to clinical presentation due to vague lower extremity or other symptoms refractory to exhaustive workup and the potential space of the retroperitoneum.
The authors retrospectively reviewed the charts of 44 patients who presented to Louisiana State University Health Sciences Center with pelvic plexus tumors. All such patients were included in the present study if there was at least 12 months of follow-up. Clinical evaluations were examined, including typical clinical presentation, imaging studies, and other preoperative evaluations. These tumors include 38 peripheral neural sheath tumors (86%), two malignant neural sheath tumors (5%), and four nonneural sheath tumors (9%). The authors also examined the relation of pelvic neural sheath tumors to neurofibromatosis Type 1 (NF1).
Histopathological examination confirmed 18 solitary neurofibromas (41%), 12 NF1-associated neurofibromas (27%), eight schwannomas (18%), two malignant nerve sheath tumors (5%), and four other nonneural sheath tumors (9%). The other nonneural sheath tumors consisted of one each of desmoid, ganglioma, lipoma, and an unspecified calcified mass.
The optimal treatment for retroperitoneal lesions remains operative excision with adjunctive therapy specific to the lesion encountered.
盆腔神经丛肿瘤是罕见的实体瘤。由于下肢症状模糊或经过全面检查仍难以确诊，以及腹膜后的潜在空间，这些病变在临床表现之前往往已发展到相当大的尺寸。
作者回顾性分析了44例因盆腔神经丛肿瘤就诊于路易斯安那州立大学健康科学中心患者的病历。如果至少有12个月的随访期，则所有此类患者均纳入本研究。检查临床评估情况，包括典型临床表现、影像学检查和其他术前评估。这些肿瘤包括38例周围神经鞘瘤（86%）、2例恶性神经鞘瘤（5%）和4例非神经鞘瘤（9%）。作者还研究了盆腔神经鞘瘤与1型神经纤维瘤病（NF1）的关系。
组织病理学检查证实有18例孤立性神经纤维瘤（41%）、12例与NF1相关的神经纤维瘤（27%）、8例神经鞘瘤（18%）、2例恶性神经鞘瘤（5%）和4例其他非神经鞘瘤（9%）。其他非神经鞘瘤分别由1例硬纤维瘤、神经节瘤、脂肪瘤和1例未明确的钙化肿块组成。
腹膜后病变的最佳治疗方法仍然是手术切除，并根据所遇到的病变进行辅助治疗。
