颅内表皮样囊肿与皮样囊肿──附25例临床分析

颅内表皮样囊肿与皮样囊肿同属先天性上皮样肿瘤，本文对２５例的临床表现、辅助检查（包括头颅Ｘ线平片、ＣＴ和ＭＲＩ）、手术治疗及并发症的处理结合有关文献进行了复习。认为头颅ＣＴ及ＭＲＩ对本类疾病诊断帮助较大，手术切除并不十分困难，如能在显微镜下全切病灶并注意保护周围蛛网膜下腔，避免无菌性脑膜炎和交通性脑积水等并发症的发生，预后多较好。     

椎管内囊肿

本文报告椎管内囊肿７例，占同期椎管内肿瘤的３．５％。介绍１例同时位于硬脊膜外与硬脊膜下累及１４个节段的巨大蛛网膜囊肿。对椎管内囊肿的诊断与治疗进行讨论。     

椎管内肠源性囊肿的诊断和治疗

我院1987～1996年间共收治椎管内肠源性囊肿18例，约占同期椎管内肿瘤的2．7％。其中14岁以下小儿15例。本病临床表现同于一般椎管内占位病变。本组中较典型的症状反复发作现象仅见于16．6％的患者。X线平片检出脊椎伴发畸形者占33．3％。作者认为对于有脊髓受压表现的儿童患者、伴发脊柱或其他系统畸形特别是症状有反复发作病史者，结合椎管造影尤其是MRI表现大部分患者能够确诊。本病治疗应以手术为主。本组病变全切12例，次全切6例。本病手术治疗难度不大。囊肿头端与脊髓常有粘连，此部分如确实分离困难可将薄层囊壁残留少量．但如有实质性结节则应尽量全切。     

椎管内肠源性囊肿16例临床分析

目的：探讨椎管内肠源性囊肿的诊断、治疗和预后。方法：回顾性分析16例椎管内肠源性囊肿的临床表现、MRI表现、治疗方法和结果。结果：全切除10例，大部分切除3例，部分切除3你。症状缓解13例，部分消失3例。结论：椎管内肠源性囊肿的诊断主要依靠MRI，治疗主要宜以显微手术切除为佳，预后良好。     

老年大脑半球内巨大表皮样囊肿一例

老年大脑半球内巨大表皮样囊肿一例云南省玉溪地区医院神经外科（６５３１００）董建平，罗志伟，董辉患者，男性，６３岁，行为异常伴大小便失禁１年余，发作性意识丧失，四肢抽搐半月收住院。查体：神清，对答切题，视乳头无水肿，神经系统检查未见阳性体征。ＣＴ检查：...     

桥小脑角表皮样囊肿的手术治疗

表皮样囊肿是最常见的中枢神经系统肿瘤样畸生物 ,菏泽地区二院及山东大学附属二院 1992年 7月～ 1998年 6月共手术治疗桥小脑角表皮样囊肿 5 2例 ,总结报告如下。1　临床资料1.1　一般资料男 2 3例 ,女 2 9例 ;年龄 16～ 6 2岁 ,平均 39岁。病史 1个月～ 17年 ,平均 2 .5年。常见的症状是面部疼痛、头晕 ,常见的体征是第Ⅴ和第Ⅷ对颅神经损害的表现。一侧面部阵发性疼痛 2 8例 ,耳鸣 2 6例 ,头晕 2 1例 ,头痛 2 3例 ,复视 5例 ,视物不清 3例 ,癫痫发作 2例 ,一侧面部麻木 4例 ,行走不稳 9例 ,眼球震颤 6例 ,角膜反射迟钝或消失 5例 ,饮水呛…     

睾丸表皮样囊肿2例

1　病例介绍病例 1,2 3岁 ,发现右侧睾丸肿块 2年 ,近半年增长加快 ,偶有轻度坠胀感 ,无疼痛 ,体验右侧睾丸上缘有 1约 2 .0 cm×1.0 cm大小包块 ,质硬 ,边界清楚 ,无明显触痛 ;B超示右侧睾丸内囊实性肿块 ,其内回声不均 ;术中见肿瘤位于睾丸上极 ,约 1.5 cm× 1.0 cm ,椭圆型 ,包膜完整 ,内呈胶冻样物 ,完整切除之 ,术后病理报告睾丸表皮样囊肿。病例 2 ,2 0岁 ,发现左侧睾丸肿块 3月余 ,有增长趋势 ,自觉轻度坠胀感和胀痛 ,体验左侧睾丸上极有 1约 0 .7cm×1.3cm大小包块 ,质硬 ,边界清楚 ,有触痛 ;B超示左侧睾丸内囊实性肿块 ,其内回声…     

睾丸表皮样囊肿一例报告

1　病例报告患者男,18岁。主诉:左睾丸肿大2个月。查体:左睾丸扪及肿块,质硬、表面光滑、无压痛。Ｂ超:左睾丸内部有一近环状强回声壁,环壁规则,直径为1.9ｃｍ,内为低回声结构,其中有不规则钙化,血流不丰富。于1999年8月2日在硬膜外麻碎下经左腹股沟行左睾丸切除术。病理报告:肿瘤囊壁被以角化鳞状上皮,囊内充满角化物质,有灶性钙化。诊断:左睾丸表皮样囊肿。2　讨论本病较为罕见,约占睾丸肿瘤的1%,青壮年多见,左右睾丸均可发生。临床多无症状或表现为阴囊肿块、坠痛,触诊睾丸肿块质地较硬。根据病史和查体往往不提示本病,而超声诊断准确率…     

Testicular dermoid cyst in an 85-year-old man

We report a case of dermoid cyst of the right testis. An 85-year-old man was admitted to our hospital with an enlarged right testicle and a high prostate specific antigen (PSA) level. A hard testis of approximately 10 cm, with a smooth surface, was palpated. On digital rectal examination, a hard prostate of approximately 4 cm, with irregular surface, was palpated. We performed right inguinal orchiectomy and transrectal ultrasound-guided prostate needle biopsy. The wall of the testis was calcified, with a cyst that contained yellow-white sebaceous material and tufts of hair. Microscopically, the cyst wall showed calcification and ossification, and had hair roots. The diagnosis was dermoid cyst. We also found a well differentiated adenocarcinoma (Gleason 2–3) in the prostate. Dermoid cyst of the testis is very rare. To our knowledge, this case is in the oldest patient thus far reported. Received: September 9, 1999 / Accepted: January 20, 2000     

颅内皮样囊肿的MRI和CT诊断

目的探讨颅内皮样囊肿的MRI和CT表现及其诊断价值。方法回顾性分析23例经手术病理证实的颅内皮样囊肿病例,对其MRI和CT表现、病理和临床特征进行分析。23例均行MRI检查,20例同时行CT检查。结果22例MRI表现T1WI和T2WI均为不均匀高信号,1例T1WI为等高信号,T2WI为低信号。8例DWI表现斑片状不均匀高信号。19例CT标准窗宽、窗位,表现为均匀低密度影,宽窗宽、低窗位,表现为不均匀低密度影。另1例CT标准窗宽、窗位,表现为高密度影。其中8例CT和MRI可见蛛网膜下腔和双侧脑室内散布的脂肪滴和间质性脑水肿。结论颅内皮样囊肿有较典型的MRI和CT表现,特别是皮样囊肿破裂有影像学和临床特征性表现,可实现术前正确诊断,MRI优于CT诊断。     

GIANT HYPERDENSE INTRADIPLOIC EPIDERMOID CYST OF THE SKULL WITH EXTRA AND INTRACRANIAL EXTENSION： REPORT OF TWO CASES AND LITERATURES REVIEW

Intradiploic epidermoid cysts, fairly uncommon lesions in neurosurgical practice, are, as a rule, benign and slow-growing. Some may attain great size. Correct radiological assessment and complete removal of the tumor and its capsule are essential for adequate surgical treatment and good long-term prognosis. We report two cases of intradiploic epidermoid cysts of the skull, with giant and CT-hyperdense lesions with extra and intracranial extension, and analyze the clinicopathological and imaging features and treatment of these lesions in the light of the most important published data.     

MRI findings of malignant transformation of epidermoid cyst: case report

Malignant transformation of epidermoid cysts into squamous cell carcinoma (SCC) rarely occurs. A 67-year-old man initially presented with an 8-year history of right trigeminal neuralgia. His symptoms had changed into right facial anesthesia with right-ear hearing impairment 8 months before first consulting a neurosurgeon at our hospital. Results obtained using MRI suggested an epidermoid cyst in the right cerebellopontine angle, but showed atypical findings of a small enhancing nodule in the periphery and surrounding edema in the cerebellum and pons. Surgery was performed to remove the mass, but a small nodule was not reached. Despite stereotactic radiosurgery, the patient’s clinical course deteriorated; he died 13 months after the first MRI examination. Autopsy revealed SCC originating from the epidermoid cyst. We present serial MRI and pathologic findings in the early and terminal phases of this patient.     

Isolated central canal rupture of spinal dermoid: Report of two cases

We report two cases of lumbar spinal dermoid cysts with asymptomatic rupture and migration of free fat droplets into the central canal. No fatty droplets were seen within the lumbar subarachnoid space. The presence of fat droplets within the central canal is unusual because the central canal is rudimentary in adults. We suggest that hydromyelia secondary to tumour and specific tumour morphology might facilitate the selective rupture of dermoids into the central canal. We recommend a follow up of these patients to detect any possible intracranial migration of fat droplets and resultant complications.     

小儿颅内表皮样囊肿的诊断与治疗:10例报告

背景与目的:表皮样囊肿(epidermoid cyst)是一种少见的良性病变,发生于小儿(<16岁)十分罕见,确诊十分困难.本文探讨小儿颅内表皮样囊肿的诊断与治疗.方法:回顾性地对我院神经外科收治的颅内表皮样囊肿10例患者的临床特点、诊断、治疗和预后进行分析.结果:10例患者中,男性4例,女性6例,中位年龄12.2岁....     

脊髓硬膜外血肿4例报告及文献复习

目的通过4例患者的随访观察及文献复习,探讨脊髓硬膜外血肿的治疗原则、病程转归和预后。方法脊髓硬膜外血肿患者4例,男2例,女2例;年龄22～75岁,随访时间7～34个月,2例手术治疗,2例保守治疗。随访包括屈髋肌、伸膝肌、小腿三头肌肌力和括约肌情况以及Epstein评分。结果手术组术后临床获得功能恢复和完全恢复,肌力Ⅳ-Ⅴ级,大小便功能完全恢复。Epstein评分优良。非手术组临床上获得不完全恢复,肌力Ⅱ-Ⅳ级,大小便功能未恢复jEpstein评分可。结论脊髓硬膜外血肿,应尽快手术治疗。早期诊断是获得最佳治疗机会的前提。保守治疗很难得到完全康复。     

儿童颅内皮样囊肿合并感染1例并文献复习

目的:探讨颅内皮样囊肿的临床表现、诊断、治疗及并发症。方法:回顾性分析我院1例颅内皮样囊肿合并感染患儿的临床资料,并结合文献复习,总结其临床表现、诊断及治疗。结果:本例患儿出现了囊内感染,经手术切除后患儿预后良好。结论:儿童颅内皮样囊肿发病率低,一般预后良好,可出现囊内感染、无菌性脑膜炎、脑积水等并发症,核磁共振在诊断中起重要作用,手术是其主要治疗方式。     

Phase II double-blind randomized study of lonidamine and radiotherapy in epidermoid carcinoma of the lung

Patients with non metastatic squamous cell lung cancer were treated with radiotherapy (RT) plus lonidamine (LND) or placebo (PLAC), according to a randomized double-blind study design.

Treatment with lonidamine 150 mg t.i.d (27 patients) or placebo (23 patients) started 3 days before RT,lasted up to 7 months. Partial responses were observed in 14 and 6 patients respectively in the LND+RT and PLAC+RT groups. Statistical analysis of the survival curves showed no significant difference between the LND+RT (median 311 days) and PLAC+RT (median 193 days) groups.

Stage III patients survived significantly longer (p<0.05) when treated with LND+RT (median 318 days) than with PLAC+RT (median 163 days). No synergistic toxic effects between radiation and LND were noted.

To confirm these data a new and larger multicentric study is now in progress.     

MR imaging of a ruptured intraspinal dermoid tumour with fat droplets in the central spinal canal

We report a patient with intramedullary ruptured spinal dermoid tumour. The MR imaging revealed an intra­medullary lumbar mass heterogenous in intensity in all sequences. Fat droplets were observed in the subarachnoid space as well as in the dilated central spinal canal. Fat droplets in the subarachnoid space are frequently seen in the rupture of intraspinal dermoid tumours; however, fat droplets within the central canal is quite rare and was unexpected. Magnetic resonance imaging is a useful tool in the determination of spinal pathologies before they become large enough to cause severe symptoms and/or morbidity.