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颞叶异位复发颅咽管瘤:病例报告及文献复习。

An Ectopic Recurrent Craniopharyngioma of the Temporal Lobe: Case Report and Review of the Literature.

机构信息

Department of Neurosurgery, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.

Department of Neurosurgery, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.

出版信息

World Neurosurg. 2019 Jun;126:216-222. doi: 10.1016/j.wneu.2019.02.196. Epub 2019 Mar 13.

Abstract

BACKGROUND

Ectopic recurrent craniopharyngioma is rare. We present a case of a temporal ectopic recurrent tumor after a trans-eyebrow supraorbital keyhole approach and provide a review of the reported data with basic statistics.

METHODS

We retrospectively reviewed 57 cases of craniopharyngiomas surgically treated at our institution. A temporal ectopic recurrent tumor with 10% high Ki-67 proliferation index expression was identified. The lesion underwent gross total resection without any complications. We also reviewed the related data and performed a basic statistical analysis.

RESULTS

Our review found 64 cases of ectopic recurrent craniopharyngioma that had been reported (including the present case). The median interval until ectopic recurrence was 4.0 years (interquartile range, 2.0-10.0). Of the 64 lesions, 48 (75%) were adamantinous, 6 (9%) were papillary, and 10 (16%) were unknown. Also, 34 tumors (53%) were located in the previous surgical tract, and 30 (47%) had disseminated along the cerebrospinal fluid pathway. Of the 64 ectopic tumors, 50 (78%) could be resected in total without complications.

CONCLUSIONS

Ectopic recurrent craniopharyngioma is a rare phenomenon. Meticulous protection of the entire surgical field and careful manipulation of the tumor during resection are required to prevent possible ectopic recurrence. Regular follow-up examinations are strongly recommended to detect any further recurrences. Gross total resection is the treatment of choice for ectopic recurrence.

摘要

背景

颅咽管瘤异位复发罕见。我们报告了 1 例经眉弓眶上锁孔入路切除后发生颞叶异位复发病例,并结合已报道数据进行基本统计学分析。

方法

我们回顾性分析了在我院接受手术治疗的 57 例颅咽管瘤患者。发现 1 例具有 10%高 Ki-67 增殖指数表达的颞叶异位复发病灶,行大体全切除,无任何并发症。我们还复习了相关数据并进行了基本统计学分析。

结果

我们的回顾性研究共发现 64 例异位复发颅咽管瘤(包括本病例),其平均复发时间为 4.0 年(四分位距 2.0-10.0)。64 个病灶中,48 个(75%)为造釉细胞瘤型,6 个(9%)为乳头型,10 个(16%)未知。此外,34 个肿瘤(53%)位于既往手术部位,30 个(47%)沿脑脊液通路播散。64 个异位肿瘤中,50 个(78%)可整块无并发症切除。

结论

颅咽管瘤异位复发罕见。需要精细保护整个手术区域,在切除肿瘤时小心操作,以防止可能的异位复发。强烈建议定期进行随访检查,以发现任何进一步的复发。大体全切除是治疗异位复发的首选方法。

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