Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana 71130-3932, USA.
J Neurosurg. 2012 Jun;116(6):1195-203. doi: 10.3171/2012.3.JNS112098. Epub 2012 Apr 13.
Some patients presenting with neurological symptoms and normal findings on imaging studies may harbor occult brain tumors that are undetectable on initial imaging. The purpose of this study was to analyze the cases of occult brain tumors reported in the literature and to determine their modes of presentation and time to diagnosis on imaging studies.
A review of the literature was performed using PubMed. The authors found 15 articles reporting on a total of 60 patients with occult tumors (including the authors' illustrative case).
Seizures were the mode of initial presentation in a majority (61.7%) of patients. The initial imaging was CT scanning in 55% and MRI in 45%. The mean time to diagnosis for occult brain tumors was 10.3 months (median 4 months). The time to diagnosis (mean 7.5 months, median 3.2 months) was shorter (p = 0.046) among patients with seizures. Glioblastoma multiforme (GBM) was found more frequently among patients with seizures (67.6% vs 34.8%, p = 0.013). The average time to diagnosis of GBM was shorter than the time to diagnosis of other tumors; the median time to diagnosis was 3.2 months for GBM and 6 months for other tumors (p = 0.04). There was no predilection for side or location of occult tumors. In adult patients, seizures may be predictive of left-sided tumors (p = 0.04).
Based on the results of this study, the authors found that in patients with occult brain tumors, the time to diagnosis is shorter among patients with seizures and also among those with GBM.
一些表现出神经系统症状且影像学检查未见异常的患者可能存在隐匿性脑瘤，这些脑瘤在初次影像学检查时无法检测到。本研究的目的是分析文献中报道的隐匿性脑瘤病例，并确定其影像学表现模式和诊断时间。
通过使用 PubMed 进行文献回顾。作者找到了 15 篇报道共 60 例隐匿性肿瘤患者（包括作者的一个说明性病例）的文章。
大多数（61.7%）患者以癫痫发作为首发症状。初始影像学检查 55%为 CT 扫描，45%为 MRI。隐匿性脑瘤的平均诊断时间为 10.3 个月（中位数为 4 个月）。癫痫发作患者的诊断时间（平均 7.5 个月，中位数 3.2 个月）较短（p = 0.046）。癫痫发作患者中更常发现多形性胶质母细胞瘤（GBM）（67.6%比 34.8%，p = 0.013）。GBM 的诊断时间短于其他肿瘤的诊断时间；GBM 的中位诊断时间为 3.2 个月，其他肿瘤的中位诊断时间为 6 个月（p = 0.04）。隐匿性肿瘤无侧别或位置偏好。在成年患者中，癫痫发作可能预示着左侧肿瘤（p = 0.04）。
根据本研究的结果，作者发现隐匿性脑瘤患者中，癫痫发作患者和 GBM 患者的诊断时间更短。
