Yamamoto M, Fukushima T, Sakamoto S, Tomonaga M
Department of Neurosurgery, Fukuoka University School of Medicine, Japan.
Surg Neurol. 1998 May;49(5):547-52. doi: 10.1016/s0090-3019(97)00219-x.
Giant cell tumors rarely occur in the sphenoid bone. When they do occur in the base of the skull, surgical treatment is frequently difficult and therefore, the use of adjuvant therapy is important. However, there remains no optimal management regimen for giant cell tumors of the sphenoid bone.
Two cases of a giant cell tumor involving the sphenoid bone that responded well to chemotherapy using adriamycin after a partial removal of the tumor are presented. In the first patient, the tumor was partially removed via a transcranial subfrontal approach and a transnasal transsphenoidal approach. In the second patient, the tumor was partially removed through a transcranial subfrontal approach. Both tumors demonstrated histologic features typical of giant cell tumors. The patients subsequently received adjuvant chemotherapy using adriamycin alone in the first patient, and chemotherapy combined with radiotherapy in the second patient. Partial regression of the tumors was later confirmed on a computed tomography (CT) scan after chemotherapy. In both patients, tumors have been stable for more than 12 years despite an incomplete removal of the tumors.
Based on the above findings, postoperative adjuvant chemotherapy using adriamycin may be effective for incompletely resected giant cell tumors of the sphenoid bone.
骨巨细胞瘤很少发生于蝶骨。当它发生于颅底时,手术治疗常常困难,因此辅助治疗的应用很重要。然而,对于蝶骨骨巨细胞瘤仍没有最佳的治疗方案。
本文报告2例累及蝶骨的骨巨细胞瘤,在肿瘤部分切除后使用阿霉素化疗效果良好。首例患者,经经颅额下入路和经鼻蝶窦入路部分切除肿瘤。第二例患者,经经颅额下入路部分切除肿瘤。两个肿瘤均表现出骨巨细胞瘤典型的组织学特征。首例患者随后单独使用阿霉素进行辅助化疗,第二例患者化疗联合放疗。化疗后计算机断层扫描(CT)证实肿瘤部分消退。两名患者尽管肿瘤切除不完全,但肿瘤已稳定超过12年。
基于上述发现,术后使用阿霉素辅助化疗可能对不完全切除的蝶骨骨巨细胞瘤有效。