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复发性脑膜瘤伴恶性转化:一例报告及文献复习

Recurrent meningioma with malignant transformation: a case report and literature review.

作者信息

Wang Junwen, Wang Lei, Luo Bo, Chen Zhi, Xiong Zuojun, Fang Mingbo, Li Jun

机构信息

Department of Neurosurgery, Wuhan Central Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology Wuhan 430014, Hubei, P. R. China.

Department of Pathology, Wuhan Central Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology Wuhan 430014, Hubei, P. R. China.

出版信息

Int J Clin Exp Med. 2015 Sep 15;8(9):16845-9. eCollection 2015.

Abstract

Meningiomas are common and mostly benign intracranial tumors, but may show a histological progression to malignancy. The mechanisms of malignant transformation remain unclear. Malignant meningiomas usually bear a high recurrence rate and unfavorable prognosis, and multiple surgical resections are required for the treatment. We report on a case of 51-year-old woman with a histologically benign intracranial meningioma. The patient had undergone multiple tumor resections and radiotherapy treatments. After multiple resections, the tumor demonstrated malignant transformation. A rapid tumor growth resulted in extensive tumor invasion of dura, brain and nasal sinus. Impaired brain function and subsequent intracranial hypertension caused serious headache, vomiting and coma. The patient survived 5 years following initial presentation. 3 subtotal resections of meningioma were performed. Radiotherapy was shown to be relatively ineffective during the course. The treatment strategies of recurrent meningiomas are briefly reviewed.

摘要

脑膜瘤是常见的颅内肿瘤,大多为良性,但可能会出现组织学上的恶性进展。恶性转化的机制尚不清楚。恶性脑膜瘤通常复发率高且预后不良,治疗需要多次手术切除。我们报告一例51岁女性,患有组织学上为良性的颅内脑膜瘤。该患者接受了多次肿瘤切除和放射治疗。多次切除后,肿瘤发生了恶性转化。肿瘤快速生长导致硬脑膜、脑和鼻窦广泛受侵。脑功能受损及随后的颅内高压引起严重头痛、呕吐和昏迷。患者在首次就诊后存活了5年。进行了3次脑膜瘤次全切除术。在病程中,放疗显示相对无效。本文简要回顾了复发性脑膜瘤的治疗策略。

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本文引用的文献

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Ectopic meningioma in the bilateral nasal olfactory cleft: A case report and literature review.
Oncol Lett. 2015 Apr;9(4):1743-1746. doi: 10.3892/ol.2015.2970. Epub 2015 Feb 17.
3
Lateral ventricular cystic meningioma: 2 rare case reports.侧脑室囊性脑膜瘤:2例罕见病例报告
Exp Ther Med. 2014 May;7(5):1393-1395. doi: 10.3892/etm.2014.1550. Epub 2014 Feb 17.
8
Giant malignant meningioma invading the calvarial bone and scalp.巨大恶性脑膜瘤侵犯颅骨和头皮。
J Craniofac Surg. 2012 Mar;23(2):599-602. doi: 10.1097/SCS.0b013e31824cd718.
9
WHO grade II and III meningiomas: a study of prognostic factors.WHO 分级 II 和 III 级脑膜瘤:预后因素研究。
J Neurooncol. 2009 Dec;95(3):367-375. doi: 10.1007/s11060-009-9934-0. Epub 2009 Jun 27.
10
Recurrent atypical meningioma seeding to surgical scar.
Neurol India. 2009 Mar-Apr;57(2):222-4. doi: 10.4103/0028-3886.51307.

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