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脑膜瘤

Meningioma

作者信息

Alruwaili Asayel A., De Jesus Orlando

机构信息

King Fahad Specialist Hospital

University of Puerto Rico, Medical Sciences Campus, Neurosurgery Section

Abstract

Meningioma is the most common primary central nervous system tumor, accounting for about 37.6% of them and approximately 50% of all benign brain tumors. Meningioma originates from the meningeal layers of either the brain or the spinal cord. These tumors are classified into three grades, according to the World Health Organization (WHO). The majority of meningiomas are benign and considered grade 1. About 1 to 3% of meningiomas can be transformed into malignant tumors with a 5-year survival rate of 32 to 64%. Several predisposing factors increase the risk of occurrence, including genetic disorders such as neurofibromatosis type 2, exposure to radiation, hormonal therapy, and family history.  The clinical manifestation is dependent on the location and the size of the meningioma. Therefore, some patients can be asymptomatic, while others might experience neurological deficits. Brain magnetic resonance imaging (MRI) is the gold standard radiological investigation for diagnosing meningioma. Asymptomatic and slow-growing meningiomas are usually managed with observation along with routine imaging. However, for fast-growing tumors, large tumors, or symptomatic patients, surgery remains the best management option. This review will primarily discuss intracranial meningiomas.

摘要

脑膜瘤是最常见的原发性中枢神经系统肿瘤,约占原发性中枢神经系统肿瘤的37.6%,占所有良性脑肿瘤的近50%。脑膜瘤起源于脑或脊髓的脑膜层。根据世界卫生组织(WHO)的分类,这些肿瘤分为三个级别。大多数脑膜瘤是良性的,属于1级。约1%至3%的脑膜瘤可转变为恶性肿瘤,其5年生存率为32%至64%。几个诱发因素会增加发病风险,包括遗传性疾病,如2型神经纤维瘤病、辐射暴露、激素治疗和家族病史。临床表现取决于脑膜瘤的位置和大小。因此,一些患者可能没有症状,而另一些患者可能会出现神经功能缺损。脑磁共振成像(MRI)是诊断脑膜瘤的金标准影像学检查。无症状且生长缓慢的脑膜瘤通常通过观察和常规影像学检查进行处理。然而,对于生长迅速的肿瘤、大型肿瘤或有症状的患者,手术仍然是最佳的治疗选择。本综述将主要讨论颅内脑膜瘤。

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