Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
World Neurosurg. 2019 May;125:e1-e9. doi: 10.1016/j.wneu.2018.11.252. Epub 2018 Dec 18.
Primary intracranial squamous cell carcinoma (SCC) is a rare neoplasm associated with malignant transformation of benign epidermoid or dermoid cysts. The optimal treatment and prognosis of this rare disease are unclear.
A comprehensive literature review identified all reports relevant to clinical presentation, treatment, and outcome of primary intracranial SCC. All available data were extracted from the included literature. Two patients diagnosed with malignant transformation of an epidermoid cyst in our institute were also included in the study. Survival analysis was conducted to determine the factors affecting patient outcomes.
A total of 62 cases were identified and selected for the present study. The median survival regardless of treatment was 12.8 months. Median survival for patients treated with surgery alone and surgery with radiotherapy was 5 months and 35 months, respectively (P = 0.037). Patients who underwent gross total resection showed relatively increased survival compared with those who underwent subtotal resection (median, 48 months vs. 25 months; P = 0.067). Patients with leptomeningeal carcinomatosis had a significantly decreased median survival of 10 months, as opposed to 41 months (P = 0.005).
Primary intracranial SCC shows poor prognosis, with controversial management. The results of this study indicate that complete resection of tumor when possible, followed by radiotherapy, is the optimal treatment for improving patient outcome.
原发性颅内鳞状细胞癌（SCC）是一种罕见的肿瘤，与良性表皮样或皮样囊肿的恶性转化有关。这种罕见疾病的最佳治疗和预后尚不清楚。
通过全面的文献回顾，确定了与原发性颅内 SCC 的临床表现、治疗和预后相关的所有报告。从纳入的文献中提取所有可用数据。本研究还纳入了我院诊断为表皮样囊肿恶性转化的 2 例患者。进行生存分析以确定影响患者结局的因素。
共确定了 62 例病例，并对其进行了研究。无论治疗与否，中位生存时间为 12.8 个月。单独手术和手术联合放疗的中位生存时间分别为 5 个月和 35 个月（P=0.037）。行大体全切除的患者与行次全切除的患者相比，生存时间相对延长（中位时间，48 个月 vs. 25 个月；P=0.067）。发生软脑膜癌病的患者中位生存时间明显缩短，为 10 个月，而无软脑膜癌病的患者中位生存时间为 41 个月（P=0.005）。
原发性颅内 SCC 预后较差，治疗方法存在争议。本研究结果表明，尽可能完全切除肿瘤，然后进行放疗，是改善患者预后的最佳治疗方法。
