Chung Sang-Bong, Kim Chae-Yong, Park Chul-Kee, Kim Dong Gyu, Jung Hee-Won
Department of Neurosurgery, Seoul National University, College of Medicine, Seoul, Korea.
J Korean Neurosurg Soc. 2007 Oct;42(4):276-80. doi: 10.3340/jkns.2007.42.4.276. Epub 2007 Oct 20.
The purpose of this study was to review the characteristics of falcine meningioma retrospectively and to identify the parameters associated with tumor recurrence.
The analysis included; age, sex, extent of resection, and radiologic and pathologic findings. Falcine meningiomas were classified by location as anterior, middle, or posterior as described for parasagittal meningiomas.
Of the 795 meningioma patients treated between 1990 and 2004 at the authors' institution, 68 patients with meningiomas arising from the falx underwent craniotomies. There were 22 male and 46 female patients (1 : 2.1). Mean age was 55 years and ranged from 14 to 77 years. Locations of falcine meningioma were; the anterior third in 33 cases, middle in 20, and posterior in 15. Mean tumor volume was 42 cc and ranged from 4 to 140 cc. In 58 of the 68 patients tumors were totally removed. Additional surgery for recurrence was performed in 6 patients over 15 years. Of these 6 patients, only two patients underwent gross total tumor resection at first operation; the other four underwent subtotal tumor resection. Based on pathologic reports, the largest tumor subtype was transitional. There were four patients with a high grade tumor-three atypical and one anaplastic meningioma. Of the 68 patients, 59 achieved a good outcome (no neurological deficit or recurrence), six had temporary complications, two suffered new permanent postoperative deficits, and the remaining one died due to severe brain swelling despite postoperative intensive care. Extent of surgical resection was found to be significantly related to tumor recurrence.
Falcine meningioma accounted for 8.5% of intracranial meningiomas and the transitional meningioma was the most common subtype of falcine meningioma. Gross total resection of tumor was the single most important predictor of an improved surgical outcome.
本研究旨在回顾大脑镰脑膜瘤的特征，并确定与肿瘤复发相关的参数。
分析内容包括年龄、性别、切除范围以及影像学和病理学检查结果。大脑镰脑膜瘤根据其位置分为前部、中部或后部，如同矢状窦旁脑膜瘤的分类方式。
1990年至2004年在作者所在机构接受治疗的795例脑膜瘤患者中，68例大脑镰脑膜瘤患者接受了开颅手术。其中男性22例，女性46例（1:2.1）。平均年龄为55岁，年龄范围为14至77岁。大脑镰脑膜瘤的位置分布为：前三分之一处33例，中部20例，后部15例。平均肿瘤体积为42立方厘米，范围为4至140立方厘米。68例患者中有58例肿瘤被完全切除。15年期间有6例患者因肿瘤复发接受了再次手术。在这6例患者中，只有2例在首次手术时实现了肿瘤全切；另外4例接受了次全切除。根据病理报告，最大的肿瘤亚型为过渡型。有4例高级别肿瘤患者，其中3例为非典型脑膜瘤，1例为间变性脑膜瘤。68例患者中，59例预后良好（无神经功能缺损或复发），6例出现暂时并发症，2例出现新的永久性术后神经功能缺损，其余1例尽管术后进行了重症监护，但因严重脑肿胀死亡。发现手术切除范围与肿瘤复发显著相关。
大脑镰脑膜瘤占颅内脑膜瘤的8.5%，过渡型脑膜瘤是大脑镰脑膜瘤最常见的亚型。肿瘤全切是改善手术预后的唯一最重要预测因素。
