脑脊膜血管外皮细胞瘤的诊断和治疗

目的探讨脑脊膜血管外皮细胞瘤诊断和治疗。方法回顾分析1984-2005年收治的32例脑脊膜血管外皮瘤,探讨其临床病理特征、临床治疗方法及预后。结果本组男女之比1.4:1;术前仅3例影像学诊断血管外皮瘤,其余均诊断为脑膜瘤。术前影像学误诊率为92%。所有病例均行手术治疗 放射治疗,27例影像学全切,4例次全切除,1例部分切除。获得随访的29例患者1年肿瘤复发率57%,所有病例免疫组化病理结果显示vimentin 。结论脑脊膜的血管外皮瘤为起源于脑脊膜问叶组织、低度恶性的肿瘤,男性多见,术前易与脑膜瘤相混淆,免疫组化病理有特征性表现;该肿瘤易复发,手术力争全切是改善预后的最重要因素;不管术中是否全切肿瘤,术后都应辅助放射治疗以改善预后。

Diagnosis and treatment of meningeal hemangiopericytoma

Objective To explore the diagnosis and treatment of meningeal hemangiopericytoma. Method Thirty-two patients with meningeal hemangiopericytoma admitted to our hospital from 1984 to 2005 were selected for this study. Clinical pathology, treatment and prognosis of meningeal hemangiopericytoma were analyzed. Results The ratio of male to female is 1.4. Only 3 patients were diagnosed as meningeal hemangiopericytoma before operation, the others were diagnosed as meningioma. The rate of misdiagnosis in imageology reaches 92%. All the patients with meningeal hemangiopericytoma were treated with surgery and radiation. 27 tumors total removed by imaging, 4 tumors were subtotal removed, noly one were partial resection. The recurrence rate for one year of the twenty-nine patients who have been followed for one year is 57%. The immunohistochemistry of all cases showed vimentin . Conclusion Meningeal hemangiopericytoma is a low-grade malignant tumor which derives from meningeal mesenchyme, most patients are male. Doctors always take hemangiopericytoma for meningioma before operation but hemangiopericytoma has distinctive immunohistochemical characteristics in pathology. This tumor could recurrent with high rate. The most important factor to improve the outcome is trying to remove the total tumor. To improve the outcome, adjuvant radiation therapy should be performed even the tumor has been removed completely.