Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China.
Department of Pathology, Hua-shan Hospital, Fudan University, Shan-ghai, China.
Oper Neurosurg (Hagerstown). 2018 Sep 1;15(3):270-277. doi: 10.1093/ons/opx233.
Chondromyxoid fibromas (CMFs) are benign tumors that occur rarely in the skull base.
To conduct a preliminary exploration of the diagnosis and treatment of cranial CMFs.
A retrospective analysis of 19 cases of CMFs in the base of the skull between 2009 and 2014 in our hospital was conducted. The clinical manifestations, imaging characteristics, pathology, treatment strategies, and outcomes were examined.
The study cohort included 7 women (36.8%) and 12 men (63.2%), and symptom duration ranged from 1 mo to 5 yr. Of the 19 intracranial CMF cases examined, 15 (78.9%) conformed with the diagnostic criteria for extracranial CMF. Resection operations yielded subtotal removal of 13 tumors (68.4%) and partial removal of 6 tumors (31.6%). Postoperative pathological analysis demonstrated that the tumors were characterized by spindle-shaped or stellate cells arranged in a myxoid matrix without mitoses or permeation. Follow-up (range 2-7.3 yr; mean, 4.4 ± 1.7 yr) revealed that symptoms improved postoperatively in 15 cases (78.9%), were maintained in 2 cases (10.5%), and worsened in 2 cases (10.5%). Imaging follow-up revealed that residual tumors were stable in 18 cases (94.7%) and enlarged in 1 case (5.3%).
An accurate diagnosis should involve comprehensive consideration of clinical, radiological, and pathological features. The treatment strategy for CMFs consists of maximizing tumor removal while protecting adjacent key structures. Postoperative stereotactic radiotherapy is appropriate for residual tumors.
软骨黏液样纤维瘤(chondromyxoid fibroma,CMF)是一种罕见发生于颅底的良性肿瘤。
初步探讨颅底 CMF 的诊断和治疗方法。
回顾性分析 2009 年至 2014 年我院收治的 19 例颅底 CMF 患者的临床资料,分析其临床表现、影像学特征、病理学特点、治疗策略及预后。
本研究共纳入 7 例女性(36.8%)和 12 例男性(63.2%)患者,症状持续时间为 1 个月至 5 年。19 例颅内 CMF 中,15 例(78.9%)符合颅外 CMF 的诊断标准。13 例肿瘤行次全切除术,6 例肿瘤行部分切除术。术后病理分析显示肿瘤由梭形或星状细胞排列在黏液样基质中,无核分裂象或浸润性生长。术后随访 2~7.3 年,平均随访时间 4.4±1.7 年,15 例(78.9%)症状改善,2 例(10.5%)症状无变化,2 例(10.5%)症状加重。影像学随访显示 18 例(94.7%)肿瘤稳定,1 例(5.3%)肿瘤增大。
准确诊断需综合考虑临床、影像学和病理学特点。CMF 的治疗策略是在最大限度切除肿瘤的同时保护毗邻的关键结构。术后立体定向放疗适用于残留肿瘤。