Harrison M J, Wolfe D E, Lau T S, Mitnick R J, Sachdev V P
Department of Neurosurgery Mount Sinai Hospital New York, New York.
J Neurosurg. 1991 Oct;75(4):564-74. doi: 10.3171/jns.1991.75.4.0564.
From the records of The Mount Sinai Hospital, seven cases which met established criteria for radiation-induced meningiomas were identified. This represents the largest series of radiogenic meningiomas documented in North America and includes both intracranial and intraspinal tumors. The records and pathological specimens were reviewed and these data analyzed with other cases retrieved from the world literature. This study reveals that radiation-induced meningiomas can be categorized into three groups based on the amount of radiation administered: 1) low dose; 2) moderate dose and miscellaneous; and 3) high dose. The overwhelming majority of cases had received low-dose irradiation (800 rad) to the scalp for tinea capitis and the second largest group resulted from high-dose irradiation for primary brain tumors (greater than 2000 rad). The unique features distinguishing radiation-induced meningiomas from other meningiomas are reviewed. Although histologically atypical tumors were common in this series, overt malignancy was not encountered. The preoperative management of these lesions should include angiography to evaluate for large-vessel occlusive vasculopathy, a known association of meningiomas induced by high-dose irradiation. Given the propensity these tumors possess for recurrence, a wide bony and dural margin is recommended at surgical resection.
从西奈山医院的记录中，识别出7例符合辐射诱发脑膜瘤既定标准的病例。这是北美记录在案的最大一组放射性脑膜瘤病例系列，包括颅内和脊髓内肿瘤。对记录和病理标本进行了审查，并将这些数据与从世界文献中检索到的其他病例进行了分析。这项研究表明，根据辐射剂量，辐射诱发的脑膜瘤可分为三组：1）低剂量；2）中等剂量及其他；3）高剂量。绝大多数病例因头癣接受了头皮低剂量照射（800拉德），第二大组是因原发性脑肿瘤接受高剂量照射（超过2000拉德）所致。本文回顾了辐射诱发脑膜瘤与其他脑膜瘤相区别的独特特征。尽管在这个病例系列中组织学上非典型肿瘤很常见，但未发现明显的恶性肿瘤。这些病变的术前管理应包括血管造影，以评估大血管闭塞性血管病变，这是高剂量辐射诱发脑膜瘤的已知关联。鉴于这些肿瘤有复发倾向，建议手术切除时切除较宽的骨质和硬脑膜边缘。
