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犬脑膜瘤:一例罕见亚型及新型寰枕基底手术入路的病例报告

Canine meningioma: a case report of a rare subtype and novel atlanto basioccipital surgical approach.

作者信息

Barreau P, Dunn K, Fourie Y

机构信息

North Kent Referrals, Warren Road, Blue Bell Hill, Kent, ME5 9RD, UK.

出版信息

Vet Comp Orthop Traumatol. 2010;23(5):372-6. doi: 10.3415/VCOT-09-12-0127. Epub 2010 Aug 25.

Abstract

OBJECTIVE

To describe a novel histological subtype of skull base and cranial cervical meningioma operated upon through an uncommon atlanto basioccipital approach.

STUDY DESIGN

Clinical case report.

ANIMAL

A seven-year-old neutered female Boxer.

METHODS

The dog was presented due to lethargic behavior, signs of head and neck pain, and ongoing tetraparesis. Neurological examination and magnetic resonance imaging led to diagnosis of a ventral spinal canal mass causing severe cord and brainstem compression and which required surgical management.

RESULTS

The mass was approached through a ventral craniectomy extending cranially on the basioccipital bone. Extemporaneous cytological examination of the mass led to confirmation of neoplastic nature of the abnormal tissue. Cytoreduction of the mass was performed using multiple cycles of curettage, lavage and suction. Histopathological examination of the tumour was consistent with a papillary variant of meningioma. Adjuvant therapy was declined by the owners. The dog improved considerably in the postoperative period, however three months after surgery signs of recurrence led to euthanasia.

CONCLUSIONS

Basioccipital craniectomy allowed a limited but sufficient approach for cytoreduction of a compressive meningioma of the brainstem and cranial cervical spinal cord. Papillary meningiomas are locally infiltrative and postoperative recurrence is common.

CLINICAL RELEVANCE

Basioccipital approach combined with cranial atlanto corpectomy can be performed to relieve compression of the caudal brainstem and cranial cervical cord.

摘要

目的

描述一种通过不常见的寰枕基底入路手术治疗的颅底和颅颈交界区脑膜瘤的新型组织学亚型。

研究设计

临床病例报告。

动物

一只7岁绝育雌性拳师犬。

方法

该犬因嗜睡行为、头颈疼痛体征及进行性四肢轻瘫就诊。经神经学检查和磁共振成像诊断为腹侧椎管肿物,导致严重脊髓和脑干受压,需手术治疗。

结果

通过在枕骨基部颅骨上颅向延伸的腹侧颅骨切除术接近肿物。对肿物进行即时细胞学检查,证实异常组织的肿瘤性质。使用多次刮除、冲洗和吸引进行肿物的肿瘤细胞减灭。肿瘤的组织病理学检查与脑膜瘤的乳头状变体一致。主人拒绝辅助治疗。该犬术后恢复良好,但术后三个月复发迹象导致实施安乐死。

结论

枕骨基部颅骨切除术为脑干和颅颈脊髓压迫性脑膜瘤的肿瘤细胞减灭提供了一种有限但足够的入路。乳头状脑膜瘤具有局部浸润性,术后复发常见。

临床意义

可采用枕骨基部入路联合寰椎椎体次全切除术缓解延髓尾部和颅颈脊髓的压迫。

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