原发性小儿颅骨肿瘤

Primary pediatric skull tumors.

作者信息

Hayden Gephart Melanie G, Colglazier Elizabeth, Paulk Kayla L, Vogel Hannes, Guzman Raphael, Edwards Michael S B

机构信息

Department of Neurosurgery, Stanford University Medical Center, Stanford, CA 94305, USA.

出版信息

Pediatr Neurosurg. 2011;47(3):198-203. doi: 10.1159/000330544. Epub 2012 Jan 31.

DOI:10.1159/000330544

PMID:22301489

Abstract

BACKGROUND/AIMS: To review the pathological distribution of pediatric primary skull tumors, and to determine the diagnostic value of lesion location, patient age and lesion size.

METHODS

A retrospective chart review identified 51 consecutive pediatric patients with 54 primary skull tumors, treated between 2005 and 2010.

RESULTS

The most common diagnoses were dermoid cysts (n = 34) and fibrous dysplasia (n = 5). While dermoid tumors could reside anywhere (sensitivity = 0.41), a midline lesion had a specificity of 0.9 and a positive predictive value of 0.88. All of the fibrous dysplasia lesions were laterally placed, with a negative predictive value (NPV) of 1. Patient age < or >5 years had a high sensitivity and NPV for dermoid cysts and fibrous dysplasia, respectively. Size appeared to be sensitive (0.91, 0.8), but not specific (0.6, 0.78), with good NPV (0.8, 0.97) when considering dermoid cysts (≤2 cm) or fibrous dysplasia (>2 cm), respectively.

CONCLUSION

Dermoid cysts followed by fibrous dysplasia are the most common primary skull tumors. Lesion location, patient age and lesion size give important clues as to the diagnosis. For the majority of cases, a clinical diagnosis based on CT is sufficient for presurgical evaluation.

摘要

背景/目的：回顾儿童原发性颅骨肿瘤的病理分布情况，并确定病变位置、患者年龄和病变大小的诊断价值。

方法

通过回顾性病历审查，确定了2005年至2010年间连续治疗的51例患有54例原发性颅骨肿瘤的儿科患者。

结果

最常见的诊断是皮样囊肿（n = 34）和纤维发育不良（n = 5）。虽然皮样肿瘤可位于任何部位（敏感性 = 0.41），但中线病变的特异性为0.9，阳性预测值为0.88。所有纤维发育不良病变均位于外侧，阴性预测值（NPV）为1。年龄<或>5岁分别对皮样囊肿和纤维发育不良具有高敏感性和NPV。大小似乎具有敏感性（0.91，0.8），但不具有特异性（0.6，0.78），分别考虑皮样囊肿（≤2 cm）或纤维发育不良（>2 cm）时，NPV良好（0.8，0.97）。