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保留功能的颈静脉孔区脑膜瘤多模态治疗

Function-Preserving Multimodal Treatment for Jugular Foramen Meningiomas.

作者信息

Ito Seiro, Saegusa Takashi, Ozawa Yoshinori, Higuchi Yoshinori, Iwadate Yasuo, Serizawa Toru, Nagano Osamu, Kageyama Yusuke, Yamakami Iwao

机构信息

Department of Neurosurgery, Chiba Rosai Hospital, Ichihara City, Chiba, Japan.

Department of Neurosurgery, Chiba University Graduate School of Medicine, Chiba City, Chiba, Japan.

出版信息

J Neurol Surg B Skull Base. 2019 Jun;80(3):239-243. doi: 10.1055/s-0038-1668137. Epub 2018 Aug 21.

Abstract

Despite being pathologically benign, jugular foramen meningioma (JFM) may be locally aggressive and spread in three compartments. Because of the complex anatomical location, radical removal of JFM usually causes serious morbidity through lower cranial nerve (LCN) deficits. To accomplish long-standing tumor control with good functional outcomes, we report function-preserving multimodal treatment (FMT) for JFM, comprising the combination of intradural tumor removal with the preservation of LCN function and stereotactic radiosurgery (RS) for the residual tumor.  This study investigated six JFM patients (five women, one man). Preoperatively, five patients showed no LCN sign.  All patients underwent function-preserving retrosigmoid intradural tumor removal, and no patient developed new LCN deficit. Three patients underwent RS for the residual tumor at 8 to 12 months after surgery. After RS, all three tumors were controlled. No patients showed tumor recurrence or new LCN deficits in the follow-up period (2 months to 8 years).  FMT for JFMs can accomplish long-standing tumor control with excellent functional outcomes.

摘要

尽管颈静脉孔脑膜瘤(JFM)在病理上是良性的,但它可能具有局部侵袭性,并在三个腔隙中扩散。由于其解剖位置复杂,JFM的根治性切除通常会因下颅神经(LCN)功能缺损而导致严重的发病率。为了实现长期的肿瘤控制并获得良好的功能结果,我们报告了一种针对JFM的保留功能的多模态治疗(FMT)方法,包括硬膜内肿瘤切除并保留LCN功能,以及对残留肿瘤进行立体定向放射外科治疗(RS)。 本研究调查了6例JFM患者(5例女性,1例男性)。术前,5例患者未出现LCN体征。 所有患者均接受了保留功能的乙状窦后硬膜内肿瘤切除术,且无一例患者出现新的LCN功能缺损。3例患者在术后8至12个月接受了残留肿瘤的RS治疗。RS治疗后,所有3例肿瘤均得到控制。在随访期(2个月至8年)内,无患者出现肿瘤复发或新的LCN功能缺损。 JFM的FMT可以实现长期的肿瘤控制,并获得优异的功能结果。

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