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单中心诊治散发性内淋巴囊肿瘤的长期经验。

Long experience for the diagnosis and treatment of sporadic endolymphatic sac tumor in a single center.

机构信息

Department of Neurosurgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, PR China.

Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, PR China.

出版信息

Clin Neurol Neurosurg. 2020 Oct;197:106078. doi: 10.1016/j.clineuro.2020.106078. Epub 2020 Jul 11.

Abstract

OBJECTIVES

Sporadic endolymphatic sac tumor (ELST) is rare. The purpose of this study was to analyze the clinical feature and surgical outcome of a single-center series of sporadic ELSTs.

PATIENTS AND METHODS

We retrospectively reviewed all cases of sporadic ELSTs operated at the Tiantan hospital between 2010 and 2020.

RESULTS

Retrospective record revealed 14 patients with sporadic ELSTs who underwent surgical management. Serum VEGF(vascular endothelial growth factor)values of 6 patients were measured on admission, and the levels were all higher than normal(0-160 ng/L, Enzyme-Linked ImmunoSorbent Assay). All patients underwent surgical treatments, and there was no significant difference in KPS before and after the operation(KPS = 88:88). The average maximum diameter of the tumor was 41 mm (range28-56 mm). After surgery, Two patients received radiation therapy, We did not encounter any case with metastatic dissemination. No deaths occurred during follow-up.

CONCLUSION

ELST is defined as an aggressive or low-grade malignant tumor, with the characteristics of local recurrence and invasion of bone growth. Sporadic cases are common, and this rare tumor provides insight into the relationship between ELST and VHL syndrome. Early surgical resection can prevent or reduce the disability of auditory vestibular symptoms, and improve the chance of complete resection and retention of hearing. As far as possible complete resection of the tumor can prolong the disease-free survival of patients. Preoperative radiotherapy or stereotactic therapy cannot control tumor growth. Postoperative radiotherapy may have a positive effect on tumor control. The high expression of VEGF in patients may be related to tumor occurrence and development.

摘要

目的

散发性内淋巴囊肿瘤(ELST)较为罕见。本研究旨在分析天坛医院单中心散发性 ELST 系列的临床特征和手术结果。

方法

我们回顾性分析了 2010 年至 2020 年期间在天坛医院接受手术治疗的所有散发性 ELST 病例。

结果

回顾性记录显示,14 例散发性 ELST 患者接受了手术治疗。入院时测量了 6 例患者的血清血管内皮生长因子(VEGF)值,所有患者的水平均高于正常水平(0-160ng/L,酶联免疫吸附法)。所有患者均接受了手术治疗,术前和术后的 KPS 无显著差异(KPS=88:88)。肿瘤的平均最大直径为 41mm(范围 28-56mm)。术后 2 例患者接受了放疗,我们未遇到任何转移播散的病例。随访期间无死亡病例。

结论

ELST 被定义为一种侵袭性或低度恶性肿瘤,具有局部复发和侵犯骨骼生长的特征。散发性病例较为常见,这种罕见肿瘤为 ELST 与 VHL 综合征之间的关系提供了新的认识。早期手术切除可预防或减少听觉前庭症状的残疾,并提高完全切除和听力保留的机会。尽可能完全切除肿瘤可以延长患者的无病生存时间。术前放疗或立体定向治疗不能控制肿瘤生长。术后放疗可能对肿瘤控制有积极作用。患者中 VEGF 的高表达可能与肿瘤的发生和发展有关。

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