Fiaschi Pietro, Piatelli Gianluca, Cama Armando, Capra Valeria, Consales Alessandro, Ravegnani Marcello, Pavanello Marco
Division of Neurosurgery, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, San Martino - IST University Hospital, Genoa, Italy.
Department of Pediatric Neurosurgery, Istituto Giannina Gaslini, Genoa, Italy.
World Neurosurg. 2019 Feb;122:e1338-e1344. doi: 10.1016/j.wneu.2018.11.044. Epub 2018 Nov 15.
Given the lack of significant responses to many queries regarding behavior, treatment options, and possible prevention of iatrogenic intraspinal inclusion tumors (IITs), we think that further clinical, radiologic, and follow-up data are mandatory to better characterize this entity. We retrospectively reviewed a series of 14 consecutive patients with IIT occurring after myelomeningocele repair. The long follow-up is a mainstay of this series and may help a better understanding of the history of this slow-growing disease. To date, this is the largest series of IITs after myelomeningocele repair reported in the literature.
A retrospective chart review was performed to identify all cases of surgically repaired myelomeningocele at the Department of Neurosurgery of G. Gaslini Children's Hospital in Genoa, from January 1993 to January 2018. Among them, data regarding patients in whom an IIT developed were recovered. The medical records of these patients and their clinical history, neurologic examination, and diagnostic workup were reviewed.
From January 1993 to January 2018, 160 cases of myelomeningocele were surgically treated. Among them, 14 cases of IIT developed. The mean time between myelomeningocele repair and IIT diagnosis was 94.7 months. The mean follow-up time was 60.1 months.
It is well established that IITs may be discovered in patients who have previously undergone myelomeningocele repair. In our series, with a long follow-up time, we describe the possible range of behavior of such lesions and the utility of surgical treatment of primary therapy. Our series confirms that residual IITs showed marked stability during our long follow-up.
鉴于针对许多有关医源性椎管内包涵体肿瘤(IITs)的行为、治疗选择及可能预防措施的询问缺乏显著的回应,我们认为进一步的临床、放射学及随访数据对于更好地描述这一实体至关重要。我们回顾性分析了一系列连续14例在脊髓脊膜膨出修补术后发生IIT的患者。长期随访是本系列研究的支柱,可能有助于更好地了解这种生长缓慢疾病的病史。迄今为止,这是文献中报道的脊髓脊膜膨出修补术后IITs的最大系列病例。
进行回顾性病历审查,以确定1993年1月至2018年1月在热那亚G.加斯利尼儿童医院神经外科接受手术修复脊髓脊膜膨出的所有病例。其中,收集了发生IIT的患者的数据。对这些患者的病历及其临床病史、神经学检查和诊断检查进行了回顾。
1993年1月至2018年1月,160例脊髓脊膜膨出患者接受了手术治疗。其中,14例发生了IIT。脊髓脊膜膨出修补术与IIT诊断之间的平均时间为94.7个月。平均随访时间为60.1个月。
众所周知,IITs可能在先前接受过脊髓脊膜膨出修补术的患者中被发现。在我们的系列研究中,通过长期随访,我们描述了此类病变可能的行为范围以及手术治疗作为主要治疗方法的效用。我们的系列研究证实,在我们的长期随访中,残留的IITs显示出显著的稳定性。