Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Department of Nuclear Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Neurol India. 2021 May-Jun;69(3):650-658. doi: 10.4103/0028-3886.319236.
The human calvaria harbors a variety of pathology and majority of them are incidentally noticed as painless swelling. The aim of the present study is to describe the histopathological subtypes of calvarial lesions, their management and factors affecting their surgical outcome at a tertiary care referral center.
All patients who underwent excision of the calvarial lesions over the last 15 years (from January 2005 to July 2019) were included in this study. Patients having calvarial pathology of infective origin and recurrent lesions were excluded. Any patient with multiple calvarial lesions who have been operated more than one time for same histopathological diagnosis was counted as one patient. We studied Karnofsky Performance Status (KPS) scores and radiological changes at 3-month follow up.
Total 65 patients were recruited in this retrospective observational study. The median age of patients in the study was 29 years (range: 8 years to 68 years). Fibrous dysplasia 20 (30.7%) was the commonest lesion while metastatic thyroid carcinoma 3 (4.6%) was the most common malignant pathology. Complete excision was performed in 51 (78.5%) of patients while in 14 (21.5%) cases, subtotal or near total decompression were achieved. After three months of surgery, there was significant improvement in the KPS score (P < 0.00001). Duration of follow up ranges from 6 months to 5 years with 4 mortality in the study.
Most of the calvarial tumors were benign and surgically addressable. The malignant lesions were scattered with diverse underlying pathology and required individualized holistic approach.
人类颅骨藏有各种各样的病变，其中大多数是无症状的肿胀。本研究旨在描述颅骨病变的组织病理学亚型、其治疗方法以及影响手术结果的因素，研究对象为一家三级转诊中心的患者。
本研究纳入了过去 15 年来（2005 年 1 月至 2019 年 7 月）接受颅骨病变切除术的所有患者。患有感染性起源和复发性病变的患者被排除在外。任何患有多个颅骨病变且因同一组织病理学诊断已接受多次手术的患者均被视为 1 例患者。我们研究了卡诺夫斯基表现状态（KPS）评分和术后 3 个月的影像学变化。
本回顾性观察研究共纳入 65 例患者。研究中患者的中位年龄为 29 岁（范围：8 岁至 68 岁）。纤维结构不良占 20 例（30.7%），是最常见的病变，而转移性甲状腺癌占 3 例（4.6%），是最常见的恶性病变。51 例（78.5%）患者行完全切除术，14 例（21.5%）患者行次全或近全减压术。术后 3 个月，KPS 评分显著改善（P < 0.00001）。随访时间从 6 个月到 5 年不等，研究中有 4 例死亡。
大多数颅骨肿瘤为良性且可通过手术治疗。恶性病变分布广泛，具有不同的潜在病理，需要个体化的整体治疗方法。
