Department of Human Neurosciences, Neurosurgery, Sapienza University, Rome, Italy.
Department of Biosciences, Biotechnologies and Biopharmaceutics, Aldo Moro University, Bari, Italy.
Neurosurg Rev. 2021 Aug;44(4):1977-1985. doi: 10.1007/s10143-020-01419-8. Epub 2020 Oct 20.
Capillary hemangiomas (CHs) of the central nervous system represent a rare diagnosed pathology. CHs are benign vascular tumors whose most common manifestations are dermal and mucous and mainly occur during childhood or adolescence, while the involvement of the central nervous system can occur in a wider age range. We conducted a PubMed research on literature published until March 2020. We only enrolled cases with histological documented presence of intracranial CH. For every case collected, we analyzed age, sex, localization, neuroimaging studies performed, the presence of extracranial CHs, symptoms, neurological deficits, extent of surgical resection (biopsy, partial or gross total), adjunct treatment received (radiotherapy, chemotherapy, Trans-Arterial Embolization TAE), and outcome. Up to March 2020, the literature review identified 52 cases to which we added the case of our personal experience. The mean age was 26 with slightly female prevalence (28 F, 25 M). The most common presenting symptom was headache (21 cases, 40%). The surgical treatment consisted of biopsy in 7 cases (13%), partial resection in 10 cases (19%), gross total resection in 31 cases (58.5%), biopsy followed by total resection in 2 cases (3%), and partial resection followed by total resection in 1 case (1.5%), and the diagnosis was obtained from an autopsy sample in 1 case (1.5%). For symptomatic lesions, surgery is a valid option to obtain histological characterization, neurological improvement, and where possible a total resection. Stereotactic radiotherapy can be used if the lesion is not surgically approachable or as an adjuvant treatment in case of partial resection, having shown good results in terms of long-term disease control.
中枢神经系统毛细血管血管瘤(CH)是一种罕见的诊断病理学。CH 是良性血管肿瘤,其最常见的表现为皮肤和黏膜,主要发生在儿童或青少年时期,而中枢神经系统的受累可发生在更广泛的年龄范围。我们对截至 2020 年 3 月发表的文献进行了 PubMed 研究。我们仅纳入了有组织学记录的颅内 CH 病例。对于每一个收集到的病例,我们分析了年龄、性别、定位、进行的神经影像学研究、是否存在颅外 CH、症状、神经功能缺损、手术切除范围(活检、部分或大体全切除)、接受的辅助治疗(放疗、化疗、经动脉栓塞 TAE)以及结果。截至 2020 年 3 月,文献复习共确定了 52 例病例,我们还增加了我们个人经验的病例。平均年龄为 26 岁,女性略多(28 例女性,25 例男性)。最常见的首发症状是头痛(21 例,占 40%)。手术治疗包括活检 7 例(13%)、部分切除 10 例(19%)、大体全切除 31 例(58.5%)、活检后全切除 2 例(3%)、部分切除后全切除 1 例(1.5%),1 例(1.5%)通过尸检样本获得诊断。对于有症状的病变,手术是获得组织学特征、改善神经功能的有效选择,在可能的情况下进行全切除。如果病变无法手术切除或部分切除后作为辅助治疗,立体定向放疗可用于治疗,在长期疾病控制方面显示出良好的效果。