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侧脑室内间变性脑膜瘤:单中心 5 例患者系列及文献复习。

Lateral Intraventricular Anaplastic Meningioma: A Series of 5 Patients at a Single Institution and Literature Review.

机构信息

Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China.

Department of Anesthesiology, People's Hospital of Deyang City, Deyang, Sichuan, P.R. China.

出版信息

World Neurosurg. 2019 Nov;131:e1-e11. doi: 10.1016/j.wneu.2018.11.184. Epub 2018 Nov 27.

DOI:10.1016/j.wneu.2018.11.184
PMID:30500581
Abstract

OBJECTIVE

Lateral intraventricular anaplastic meningiomas (LIAMs) are rare lesions. The aim of this study is to clarify clinical and radiologic characteristics and the optimal treatment strategies of LIAMs with long-term follow-up.

METHODS

From September 2008 to September 2017, 5 patients with LIAM were enrolled in our study. The clinical profiles, radiologic features, treatment strategies, and outcomes were retrospectively analyzed.

RESULTS

Five patients (all female; mean age, 48.8 years; range, 33-61 years) were included in this study. The most frequent symptoms were those related to increased intracranial pressure. Mean duration of symptoms was 6.7 months (range, 2 weeks-2 years). The average tumor size was 4.98 cm at the maximal diameter (range, 3.0-6.2 cm). All were confirmed with a diagnosis of anaplastic meningioma. Gross total resection was achieved in all 5 patients. All patients experienced improvement of symptoms. Recurrence and progression were identified in only 2 patients. At the last follow-up, the mean recurrence-free survival was 13 months (range, 7-21 months) and the mean overall survival was 16.25 months (range, 8-21 months). One patient was lost to follow-up.

CONCLUSIONS

Female and right trigone area predominance were found in our case series. Shorter duration of symptoms, irregular tumor shape, peritumoral edema, and heterogeneous enhancement may indicate an aggressive feature. Maximal safe resection followed by radiation therapy may be the best strategy for patients with LIAM. Long-term clinical follow-up and serial imaging are recommended.

摘要

目的

侧脑室内间变性脑膜瘤(LIAMs)较为罕见。本研究旨在通过长期随访,明确 LIAMs 的临床和影像学特征及最佳治疗策略。

方法

2008 年 9 月至 2017 年 9 月,本研究共纳入 5 例 LIAM 患者。回顾性分析患者的临床资料、影像学特征、治疗策略及转归。

结果

本研究共纳入 5 例女性患者(平均年龄 48.8 岁,范围 33-61 岁)。最常见的症状与颅内压增高有关。症状持续时间平均为 6.7 个月(范围 2 周-2 年)。肿瘤最大径平均为 4.98cm(范围 3.0-6.2cm)。所有患者均诊断为间变性脑膜瘤。5 例患者均达到肿瘤全切除。所有患者的症状均得到改善。仅 2 例患者复发和进展。末次随访时,无进展生存时间的平均为 13 个月(范围 7-21 个月),总生存时间的平均为 16.25 个月(范围 8-21 个月)。1 例患者失访。

结论

本研究中,LIAMs 患者以女性和右侧三角区多见。症状持续时间较短、肿瘤形状不规则、瘤周水肿和不均匀强化可能提示侵袭性特征。最大限度地安全切除肿瘤并辅以放疗可能是 LIAM 患者的最佳治疗策略。建议对患者进行长期临床随访和定期影像学检查。

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