Geng Sumin, Zhang Junting, Zhang Li-Wei, Wu Zhen, Jia Guijun, Xiao Xinru, Hao Shuyu
Department of Neurosurgery, Beijing Tiantan Hospital of Capital Medical University, Beijing 100050, P.R. China.
Oncol Lett. 2014 Jul;8(1):301-304. doi: 10.3892/ol.2014.2072. Epub 2014 Apr 16.
Chondromas and chondrosarcomas of the cranial base are rare neoplastic diseases. The aim of the present study was to evaluate the diagnosis and microsurgical treatment of these difficult cranial base tumors. A total of 19 patients who underwent microsurgery were pathologically diagnosed with cranial base chondromas or chondrosarcomas and their clinical data was reviewed. The chondromas and chondrosarcomas of the cranial base in the present study commonly originated in the sphenopetrosal, sphenoclival or petroclival junctions, and the majority were located in the parasellar region of the middle cranial base extradurally. The most frequent symptoms were headaches and cranial nerve palsy, and the Karnofsky performance score (KPS), assessed pre-operatively, averaged at 87.1. A frontotemporal or preauricular subtemporal-infratemporal approach was used in 11 cases, a tempo-occipital transtentorial or presigmoid supratentorial-infratentorial approach was employed in six further cases, and the far-lateral or retrosigmoid approach was applied in the remaining two cases. A total or near-total tumor removal was secured in 13 cases, while a subtotal removal was obtained in another five and a partial removal was achieved in one case. The most common post-operative complications included cranial nerve palsy and cerebrospinal fluid leakage, but there were no post-operative fatalities. A total of 15 patients were followed up for a mean of 67.2 months (range, 5-140 months), and 13 (76.5%) of these patients were living normal lives (KPS, 80-90). There were two patients with recurrent tumors. The neuroradiological examinations and the presenting symptoms and signs allow the pre-operative diagnosis to be presumed for the majority of cranial base chondromas or chondrosarcomas. Surgical resection is the key treatment for these tumors, and this treatment is known to improve the survival rates.
颅底软骨瘤和软骨肉瘤是罕见的肿瘤性疾病。本研究的目的是评估这些难治性颅底肿瘤的诊断和显微外科治疗。对19例行显微手术的患者进行病理诊断为颅底软骨瘤或软骨肉瘤，并回顾其临床资料。本研究中的颅底软骨瘤和软骨肉瘤通常起源于蝶岩、蝶枕或岩枕交界处，大多数位于中颅底硬膜外鞍旁区域。最常见的症状是头痛和颅神经麻痹，术前评估的卡氏功能状态评分（KPS）平均为87.1。11例采用额颞或耳前颞下-颞下途径，另外6例采用颞枕经小脑幕或乙状窦前幕上-幕下途径，其余2例采用远外侧或乙状窦后途径。13例实现了肿瘤全切或近全切，另外5例为次全切除，1例为部分切除。最常见的术后并发症包括颅神经麻痹和脑脊液漏，但无术后死亡病例。15例患者平均随访67.2个月（范围5 - 140个月），其中13例（76.5%）生活正常（KPS，80 - 90）。有2例患者肿瘤复发。神经放射学检查以及出现的症状和体征有助于对大多数颅底软骨瘤或软骨肉瘤进行术前诊断。手术切除是这些肿瘤的关键治疗方法，已知这种治疗可提高生存率。
