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小儿颅咽管瘤全切术后的异位复发:两例报告及文献复习

Ectopic recurrence of pediatric craniopharyngiomas after gross total resection: a report of two cases and a review of the literature.

作者信息

Du Can, Feng Cheng-Yuan, Yuan Jian, Yuan Xianrui

机构信息

Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.

The Institute of Skull Base Surgery and Neuro-oncology at Hunan, Neurosurgery Institute of Central South University, 87 Xiangya Road, Changsha, Hunan, 410008, People's Republic of China.

出版信息

Childs Nerv Syst. 2016 Aug;32(8):1523-9. doi: 10.1007/s00381-016-3050-1. Epub 2016 Mar 11.

Abstract

INTRODUCTION

Ectopic recurrent craniopharyngioma is rare. We reported two pediatric cases and reviewed the related literature.

METHOD

We retrospectively studied 177 craniopharyngioma cases treated by the senior author (Yuan X) between years 2003 and 2013. Two ectopic recurrent craniopharyngiomas were identified. One was discovered under the right frontal lobe and the other was found in the fourth ventricle. Both patients underwent a second radical resection without complications. Then we conducted an extensive review of peer-reviewed, English-language literatures in the US National Library of Medicine, focusing on the treatment modalities, recurrent sites, and clinical outcomes.

RESULTS

Sixty ectopic recurrent tumors have been reported so far (including this study). Thirty-three tumors were located in the previous surgical corridors and 27 were disseminated along the cerebrospinal fluid pathway. All recurrent tumors were surgically removed. The gross total resection (GTR) rates were 87 and 63 %, respectively.

CONCLUSION

The natural course of recurrent ectopic craniopharyngiomas is progressive. GTR is the treatment of choice. Regular follow-ups are strongly recommended to detect any further recurrence.

摘要

引言

异位复发性颅咽管瘤罕见。我们报告了两例儿科病例并回顾了相关文献。

方法

我们回顾性研究了资深作者(袁X)在2003年至2013年期间治疗的177例颅咽管瘤病例。发现两例异位复发性颅咽管瘤。一例位于右额叶下方,另一例位于第四脑室。两名患者均接受了二次根治性切除,无并发症。然后我们对美国国立医学图书馆经同行评审的英文文献进行了广泛回顾,重点关注治疗方式、复发部位和临床结果。

结果

迄今为止,已报告60例异位复发性肿瘤(包括本研究)。33例肿瘤位于先前的手术通道内,27例沿脑脊液途径播散。所有复发性肿瘤均通过手术切除。大体全切除(GTR)率分别为87%和63%。

结论

复发性异位颅咽管瘤的自然病程呈进行性。GTR是首选治疗方法。强烈建议定期随访以发现任何进一步的复发。

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