Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
Neurosurgery. 2011 Mar;68(1 Suppl Operative):90-4; discussion 94. doi: 10.1227/NEU.0b013e3181fdf912.
Myxopapillary ependymomas usually occur in the filum terminale of the spinal cord.
This report summarizes our experience treating myxopapillary ependymomas.
The records of 34 patients (14 men, 20 women; mean age 45.5 years; age range, 14-88 years) who underwent resection of a myxopapillary ependymoma between 1983 and 2006 were reviewed for age, sex, tumor location, symptoms at diagnosis, duration of symptoms, treatment before presentation, extent of surgical resection, adjuvant therapy, length of follow-up, evidence of recurrence, and complications. Neurological examinations performed at presentation, immediately after surgery, and last follow-up were graded according to the McCormick grading scale.
The average duration of symptoms before diagnosis was 22.2 months. The most common symptom was pain followed by weakness, bowel/bladder symptoms, and numbness. The rate of gross total resection was 80%. All patients with a subtotal resection (20%) underwent postoperative radiation therapy. Presentation and outcomes of patients who underwent subtotal resection followed by radiation therapy were compared with those who underwent gross total resection. There was no significant difference in neurological grade between the groups at presentation or final follow-up. The overall recurrence rate was 10% (3/34 patients).
The goal of surgical treatment of myxopapillary ependymomas is resection to the greatest extent possible with preservation of function. In cases of subtotal resection, postoperative radiation therapy may improve outcome. If neurological function is maintained at treatment, these indolent lesions allow years of good function.
黏液乳头状室管膜瘤通常发生在脊髓的终丝。
本报告总结了我们治疗黏液乳头状室管膜瘤的经验。
回顾了 1983 年至 2006 年间 34 例（男 14 例，女 20 例；平均年龄 45.5 岁；年龄范围 14-88 岁）接受黏液乳头状室管膜瘤切除术患者的记录，包括年龄、性别、肿瘤位置、诊断时的症状、症状持续时间、就诊前的治疗、手术切除的范围、辅助治疗、随访时间、复发证据和并发症。根据 McCormick 分级量表对就诊时、手术后即刻和最后随访时的神经功能检查进行分级。
平均诊断前症状持续时间为 22.2 个月。最常见的症状是疼痛，其次是无力、肠/膀胱症状和麻木。大体全切除率为 80%。所有行次全切除术（20%）的患者均接受术后放疗。比较了行次全切除加放疗和行大体全切除的患者的表现和结局。两组患者就诊时和最终随访时的神经功能分级均无显著差异。总的复发率为 10%（3/34 例）。
黏液乳头状室管膜瘤的手术治疗目标是尽可能大范围切除肿瘤，同时保留功能。在次全切除的情况下，术后放疗可能会改善结局。如果神经功能在治疗后保持不变，这些惰性病变可以让患者在多年内保持良好的功能。
