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大型外侧侧脑室肿瘤 - 根治性手术的结果。

Large lateral intraventricular tumors - Outcome of radical surgery.

机构信息

Department of Neurosurgery, K.E.M. Hospital and Seth G.S. Medical College, Parel, Mumbai, India.

Department of Neurosurgery, K.E.M. Hospital and Seth G.S. Medical College, Parel, Mumbai, India.

出版信息

J Clin Neurosci. 2021 Jun;88:205-212. doi: 10.1016/j.jocn.2021.03.040. Epub 2021 Apr 14.

DOI:10.1016/j.jocn.2021.03.040
PMID:33992185
Abstract

This is a retrospective analysis of 145 cases of lateral intraventricular tumors that were larger than 4 cm in their maximum dimension. The aim of surgery was radical tumor resection. During the period January 2000 to December 2019, 145 cases of lateral intraventricular tumors were treated by surgery by an interhemispheric approach. There were 101 males and 44 females. The ages of the patients ranged from 2 months to 77 years (average 29 years). Histological examination of tumors identified 73 central neurocytomas, 20 choroid plexus papillomas, 23 subependymal giant cell astrocytomas (SEGA), 5 ependymomas, 21 gliomas, 2 primitive neuroectodermal tumors (PNET/embryonal tumors) and 1 atypical teratoid rhabdoid tumor (ATRT). Nineteen patients had mild to severe hemiparesis in the immediate post-operative period. Eight patients died in the postoperative period. At a follow up of 1 year 137 patients were leading active and symptom free lives. Twenty seven patients received adjuvant radiation treatment. At a follow-up of more than 3 years, 8 additional patients died of their disease. Tumor recurrence or re-growth was observed in 13 patients and 2 patients needed reoperation. Surgery on large lateral intraventricular tumors can be associated with significant postoperative morbidity and mortality. Majority of tumors in this location are relatively 'low-grade' malignant tumors and when successfully treated, the long term outcome can be gratifying.

摘要

这是对 145 例最大径大于 4cm 的侧脑室内肿瘤的回顾性分析。手术的目的是进行根治性肿瘤切除术。2000 年 1 月至 2019 年 12 月期间,通过经侧脑室外侧入路对 145 例侧脑室内肿瘤进行了手术治疗。其中男性 101 例,女性 44 例。患者年龄 2 个月至 77 岁(平均 29 岁)。肿瘤的组织学检查确定了 73 例中枢神经细胞瘤、20 例脉络丛乳头状瘤、23 例室管膜下巨细胞星形细胞瘤(SEGA)、5 例室管膜瘤、21 例胶质瘤、2 例原始神经外胚层肿瘤(PNET/胚胎瘤)和 1 例非典型畸胎样横纹肌样瘤(ATRT)。19 例患者在术后即刻出现轻至重度偏瘫。8 例患者在术后死亡。随访 1 年时,137 例患者生活活跃,无症状。27 例患者接受了辅助放疗。随访 3 年以上时,又有 8 例患者因疾病死亡。13 例患者观察到肿瘤复发或再生长,2 例患者需要再次手术。大型侧脑室内肿瘤的手术可能伴有显著的术后发病率和死亡率。该部位的大多数肿瘤都是相对“低度恶性”的肿瘤,当成功治疗时,长期预后可以令人满意。

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引用本文的文献

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Intraventricular Tumors: Surgical Considerations in Lateral and Third Ventricular Tumors.脑室肿瘤:侧脑室和第三脑室肿瘤的手术考虑因素。
Adv Tech Stand Neurosurg. 2024;50:63-118. doi: 10.1007/978-3-031-53578-9_3.
2
Clinical outcomes after microsurgical resection of giant lateral ventricular meningiomas.巨大侧脑室脑膜瘤显微手术切除后的临床结果
Neurosurg Rev. 2023 Jan 6;46(1):33. doi: 10.1007/s10143-022-01932-y.