Bruce J N, Stein B M
Department of Neurosurgery, New York Neurological Institute, Columbia University College of Phyicians and Surgeons, New York, USA.
Acta Neurochir (Wien). 1995;134(3-4):130-5. doi: 10.1007/BF01417679.
The authors advocate an aggressive surgical approach to pineal region tumors to provide a definitive histological diagnosis and to facilitate extensive tumor removal. This strategy is based on their surgical experience in 160 operations for pineal region tumors in which operative mortality was 4% with 3% permanent major morbidity. One-third of pineal tumors were benign for which surgery alone was usually curative. A gross total removal was possible in 31 of 107 malignant tumors. The supracerebellar infratentorial approach was preferred in 86% of patients. The tumors displayed considerable histological diversity with germ cell tumors most common (37%), followed by glial cell tumors (28%) and pineal cell tumors (23%). Mixed tumors occurred 15% of the time. Spinal metastases were rare, occurring in less than 10% of patients with malignant tumors. These results with a large series of pineal region tumors demonstrate the safety and efficacy of aggressive pineal tumor surgery.
作者主张对松果体区肿瘤采取积极的手术方法，以提供明确的组织学诊断并便于广泛切除肿瘤。该策略基于他们对160例松果体区肿瘤手术的经验，其中手术死亡率为4%，永久性严重并发症发生率为3%。三分之一的松果体肿瘤是良性的，通常仅手术即可治愈。107例恶性肿瘤中有31例可能实现全切除。86%的患者首选小脑上幕下入路。肿瘤显示出相当大的组织学多样性，生殖细胞肿瘤最常见（37%），其次是胶质细胞瘤（28%）和松果体细胞肿瘤（23%）。混合性肿瘤占15%。脊柱转移很少见，在恶性肿瘤患者中发生率不到10%。这一系列大量松果体区肿瘤的结果证明了积极的松果体肿瘤手术的安全性和有效性。
