Pop Maria Mihaela, Bouros Dragos, Klimko Artsiom, Pop Laura Ancuta, Topal Paula, Topal Anil, Florian Ioan Stefan
Department of Neurosurgery, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
Clinic of Neurosurgery, Cluj County Emergency Clinical Hospital, 400347 Cluj-Napoca, Romania.
Cancers (Basel). 2024 Aug 7;16(16):2788. doi: 10.3390/cancers16162788.
: Tumor-like lesions at the craniovertebral junction mimic tumors in clinical presentation and imaging. Our study focuses on three common developmental pathologies-epidermoids, dermoids and neurenteric cysts. : We conducted a retrospective analysis of a case series and a meta-analysis of 170 patients from 119 reports. : Neurenteric cysts predominated (81.2%). Anterior cysts were linked to neurenteric cysts, while posterior ones correlated with dermoid/epidermoid cysts ( < 0.001). Complications occurred in 27.2% of cases, with cranial nerve paresis being the most common. Most patients had excellent outcomes (75.2%) with low recurrence rates (12%). Dermoid cysts were more associated with anomalies ( < 0.001). Among 138 neurenteric cyst cases, 15 experienced recurrence, with predictors including ages 51-60 and over 70, subtotal resection, complications, and poor outcomes ( < 0.001). Cysts with total resection were significantly less likely to adhere to surrounding brain tissue ( < 0.001). CSF diversion was correlated with older age ( = 0.010) and various complications ( < 0.001). Age affected outcomes, and the hydrocephalus was linked to poor outcomes ( = 0.002). This meta-analysis underscores the importance of total resection in minimizing recurrence rates and emphasizes meticulous preoperative planning and imaging. Our results indicate that rim enhancement ( = 0.047) and poor outcome ( = 0.007) are significant factors associated with recurrence. Additionally, associated anomalies, as well as the patient's age and overall health, significantly influence the surgical outcomes and the likelihood of recurrence.
颅颈交界区的肿瘤样病变在临床表现和影像学上与肿瘤相似。我们的研究聚焦于三种常见的发育性病变——表皮样囊肿、皮样囊肿和神经肠囊肿。我们对一个病例系列进行了回顾性分析，并对119篇报告中的170例患者进行了荟萃分析。神经肠囊肿占主导（81.2%）。前部囊肿与神经肠囊肿相关，而后部囊肿与皮样/表皮样囊肿相关（<0.001）。27.2%的病例出现并发症，其中脑神经麻痹最为常见。大多数患者预后良好（75.2%），复发率较低（12%）。皮样囊肿与异常的相关性更高（<0.001）。在138例神经肠囊肿病例中，15例复发，复发的预测因素包括年龄51 - 60岁和70岁以上、次全切除、并发症及预后不良（<0.001）。完全切除的囊肿与周围脑组织粘连的可能性显著降低（<0.001）。脑脊液分流与年龄较大（=0.010）及各种并发症相关（<0.001）。年龄影响预后，脑积水与预后不良相关（=0.002）。这项荟萃分析强调了完全切除在降低复发率方面的重要性，并强调了细致的术前规划和影像学检查的重要性。我们的结果表明，边缘强化（=0.047）和预后不良（=0.007）是与复发相关的重要因素。此外，相关异常以及患者的年龄和整体健康状况显著影响手术结果和复发可能性。
