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[放射敏感性脑膜瘤——1例报告]

[Radiosensitive meningioma--report of a case].

作者信息

Koga H, Kinoshita K, Yamakawa Y, Wakisaka S

出版信息

No Shinkei Geka. 1986 Mar;14(3 Suppl):453-8.

PMID:3703150
Abstract

The patient was a 24-year-old male who was admitted to the Dept. of Neurosurgery of Miyazaki Medical College in April of 1982 with a history of generalized convulsive seizures. Neurological examination on admission revealed slight mental disturbance, bilateral marked papilloedema and homonymous right upper quadrantanopsia. Plain skull X-ray films showed a destructive change of the bone in the left sphenoid ridge and sella floor. CT scan showed a huge mass of slightly high density in the left anterior and middle fossae with a marked enhancement with contrast media. It was fed mainly by the left anterior and middle cerebral arteries and partly by the left middle meningeal artery on angiogram. The tumor was considered to be a type of malignant meningioma originating from the left sphenoid ridge. Total removal of the tumor without any morbidity was thought to be difficult because of its size, hypervascularity and location. From clinical and radiological features, this tumor was thought to be an angioblastic meningioma of hemangiopericytoma type and to be radiosensitive. Cobalt-60 irradiation to the tumor was attempted with a total dose of 49 Gy for over a period of 6 weeks. CT scan performed at the stage of 23 Gy-irradiation showed high radiosensitivity of the tumor and CT scan two weeks after the completion of irradiation showed a marked reduction of its volume to one third. The patient became free from headache and memory disturbance after radiotherapy. On the forty eighth day after completion of the irradiation, the tumor was totally removed with ease and minimal bleeding.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

该患者为一名24岁男性,于1982年4月因全身性惊厥发作病史入住宫崎医科大学神经外科。入院时的神经系统检查发现有轻微精神障碍、双侧明显视乳头水肿和右侧同向性象限盲。头颅X线平片显示左侧蝶骨嵴和鞍底骨质有破坏改变。CT扫描显示左侧前颅窝和中颅窝有一巨大的略高密度肿块,注入造影剂后有明显强化。血管造影显示该肿瘤主要由左侧大脑前动脉和大脑中动脉供血,部分由左侧脑膜中动脉供血。该肿瘤被认为是起源于左侧蝶骨嵴的一种恶性脑膜瘤。由于肿瘤的大小、高血运和位置,认为难以完全切除且无任何并发症。从临床和影像学特征来看,该肿瘤被认为是血管外皮细胞瘤型的血管母细胞性脑膜瘤,对放疗敏感。尝试对肿瘤进行钴-60照射,总剂量为49 Gy,照射时间超过6周。在照射至23 Gy阶段进行的CT扫描显示肿瘤对放疗高度敏感,照射完成后两周的CT扫描显示其体积明显缩小至原来的三分之一。放疗后患者头痛和记忆障碍消失。照射完成后的第48天,肿瘤轻松地被完全切除,出血极少。(摘要截选至250字)

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Radiosensitive meningioma.放射敏感型脑膜瘤
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