Ozgiray Erkin, Perumal Karthikeyan, Cinar Celal, Caliskan Kadir Emre, Ertan Yesim, Yurtseven Taskin, Oktar Nezih, Ovul Izzet, Oner Kazim
Ege University, School of Medicine, Department of Neurosurgery, Izmir, Turkey.
Turk Neurosurg. 2016;26(5):690-8. doi: 10.5137/1019-5149.JTN.12537-15.0.
Tumors of various organs that metastasize to bone do not neglect calvarium as a target. The aim of this study was to characterize the calvarial tumors.
We retrospectively reviewed 45 consecutive patients operated for calvarial masses from January 2002 till May 2012 at our hospital. Skull base tumors and patients ≤18 years were excluded.
Three groups of lesions were found - calvarial metastases (15/45), primary tumors (5/45) and tumor-like lesions (25/45). Malignant lesions were equitable by gender distribution, higher age of onset (median age of primary =55; secondary = 60 years) and benign lesions by younger age (median = 35) and female bias (18/25). Calvarial metastases mostly presented with local swelling (10/15), local pain (6/15) and rarely neurologic deficit. There was associated dural sinus thrombosis (4/20 of malignant; 1/25 of benign lesions) and osteolysis (3/5 primary malignant, 13/15 secondary and 18/25 of benign lesions). Complete surgical excision was possible with minimal morbidity in all except one patient and nil mortality.
Nearly half (20/45) of the calvarial lesions tend to be malignant with most of them presenting as silent painless masses. Surgical excision should be considered only after suitable investigation and appropriate neurosurgical set-up.
转移至骨的各种器官肿瘤不会忽视将颅骨作为转移目标。本研究的目的是对颅骨肿瘤进行特征描述。
我们回顾性分析了2002年1月至2012年5月在我院接受颅骨肿物手术的45例连续患者。排除颅底肿瘤和年龄≤18岁的患者。
发现三组病变——颅骨转移瘤（15/45）、原发性肿瘤（5/45）和肿瘤样病变（25/45）。恶性病变在性别分布上无差异，发病年龄较高（原发性肿瘤中位年龄=55岁；继发性肿瘤中位年龄=60岁），而良性病变发病年龄较轻（中位年龄=35岁）且女性居多（18/25）。颅骨转移瘤大多表现为局部肿胀（10/15）、局部疼痛（6/15），很少出现神经功能缺损。存在相关的硬脑膜窦血栓形成（恶性病变20例中有4例；良性病变25例中有1例）和骨质溶解（原发性恶性肿瘤5例中有3例，继发性肿瘤15例中有13例，良性病变25例中有18例）。除1例患者外，所有患者均能在最小程度的并发症下实现完全手术切除，且无死亡病例。
近一半（20/45）的颅骨病变倾向于为恶性，其中大多数表现为无症状的无痛性肿物。仅在进行适当检查和具备合适的神经外科手术条件后才应考虑手术切除。
