儿童脑膜瘤的临床特点及治疗:附12例报告并文献复习。

PubMed ID
发表日期 2008年月

原始出处 小儿神经外科
Pediatric neurosurgery
作者 Liu  Yuguang  Li  Feng  Zhu  Shugan  Liu  Meng  Wu  Chengyuan 

文献标题 儿童脑膜瘤的临床特点及治疗:附12例报告并文献复习。
Clinical features and treatment of meningiomas in children: report of 12 cases and literature review.

文献摘要 OBJECTIVE

探讨小儿脑膜瘤的临床特点及治疗方法。

METHODS

回顾性分析了186例儿童脑膜瘤的性别、年龄分布、症状、体征、影像学及病理学表现、治疗及预后,其中齐鲁医院收治12例,文献报道8例。

RESULTS

男孩和女孩的比例是2.3:1。年龄0.5~15岁,平均9.9岁。颅神经紊乱(28%)和慢性颅内压增高症状如头痛(62%)、呕吐(53%)和乳头水肿(55%)是最常见的症状。最常见的部位是脑凸(41%),其次是脑室(15%)、鞍区(8%)、桥小脑角(8%)、脑实质内瘤(5%)、矢状窦旁区(4%)等,密度均匀者占62.3%,钙化者占14.8%,囊性成分占21.3%,瘤内出血占1.6%。上皮型和纤维母细胞型脑膜瘤平均占55%,恶性或非典型脑膜瘤平均占9%。肿瘤完全切除率74%,术后死亡率3.3%。

CONCLUSIONS

与成人脑膜瘤相比,儿童脑膜瘤主要发生在男性,癫痫发病率较低,且常伴有多发性神经纤维瘤病。儿童脑膜瘤的预后比成人差。肿瘤初次切除程度、肿瘤部位、病理分级及与神经纤维瘤病的关系是影响患者预后的重要因素。


OBJECTIVE

To study the clinical characteristics and treatment of meningiomas in children.

METHODS

One hundred and sixty-six meningiomas in children, including 12 cases treated in Qilu hospital and 8 series reported in the literature, were analyzed retrospectively on sex, age distribution, presenting symptoms, signs, radiological and pathological findings, treatment and prognosis.

RESULTS

The ratio of boys and girls was 2.3:1. The age ranged from 0.5 to 15 years (mean 9.9 years). Cranial nerve disorder (28%) and signs of chronic increased intracranial pressure such as headaches (62%), vomiting (53%) and papilledema (55%) were the most common symptoms. The most common location was the cerebral convexity (41%), followed by ventricles (15%), saddle areas (8%), cerebellopontine angles (8%), brain intraparenchyma (5%), parasagittal regions (4%), etc. Homogeneous density was observed in 62.3% of all cases, calcification in 14.8%, cystic components in 21.3% and intratumoral hemorrhage in 1.6%. On average, the epithelial and fibroblastic types of meningiomas took up 55% of the case, while the amount of malignant or atypical meningiomas averaged 9%. Complete tumor excision was achieved in 74%, and postoperative mortality was 3.3%.

CONCLUSIONS

Compared with meningiomas in adults, meningiomas in children occur predominantly in males with a lower incidence rate of epilepsy, and are frequently associated with multiple neurofibromatosis. Meningiomas in children have a poorer prognosis than those in adults. Degree of the first tumor resection, tumor location, pathological grade and association with neurofibromatosis are the most important factors influencing the patients' prognoses.


获取全文 10.1159/000113112