Fractionated stereotactic radiotherapy for acoustic neuroma: single-institution experience at The Princess Margaret Hospital

BACKGROUND: The clinical outcome and toxicity of fractionated stereotactic radiotherapy (FSRT) was assessed for acoustic neuroma in 60 patients treated in a single institution. METHODS: Between October 1996 and February 2005, 60 patients received FSRT for acoustic neuroma (AN). The mean total dose applied was 50 Gy in single daily 2-Gy fractions over 5 weeks. The median irradiated tumor volume was 4.9 cm(3) (range, 0.3-49.0 cm(3)). The median follow-up period was 31.9 months. RESULTS: FSRT was well tolerated in all patients. The 5-year actuarial local control rate was 96.2% (95% CI: 91.1%-100.0%). Five-year actuarial progression-free survival was 92.8% (95% CI: 84.8%-100.0%). The overall hearing preservation rate was 77.3%. Five of 6 patients with initial cranial nerve V (CNV) numbness remained stable post-FSRT. Two of 3 patients with baseline trigeminal neuralgia improved with the remaining patient stable. All 3 patients with nonsurgically related facial nerve weakness either improved or achieved stability in function. There were no cases of new cranial nerve toxicity post-FSRT. CONCLUSIONS: FSRT for the treatment of AN is safe, effective, and well tolerated. FSRT should thus be considered as an effective alternative treatment modality when compared with microsurgical resection or single fraction stereotactic radiosurgery.     

Multiple Endocrine Neoplasia Type 2B: Early Diagnosis by Multiple Mucosal Neuroma and Its DNA Analysis

Multiple endocrine neoplasia type 2B (MEN 2B) is a rare disease caused by germline mutations in the RET proto-oncogene and is transmitted in an autosomal dominant fashion. It is characterized by medullary thyroid carcinoma, pheochromocytoma and mucosal neuroma developing in the tongue, lip, intestinal tract, palate etc. Among these neoplasias, mucosal neuroma generally develops from early childhood. Therefore, early detection and proper treatment can minimize the disease course. Here we describe a 9-year-old male who presented with multiple verrucous papules and nodules on his lips, tongue and gingiva that were there since birth. Histologic findings of his lips and tongue showed well-defined nerve bundles and DNA analysis revealed a M918T mutation at codon 918 of the RET oncogene. He was diagnosed early as having MEN 2B according to his genetic and phenotypic features.     

136例听神经瘤性别差异和左右发病情况的中西医结合分析

目的 对听神经瘤的性别差异和左右发病情况进行中西医结合分析。方法 回顾性分析2011年7月至2015年7月收治及手术治疗的听神经瘤患者的临床资料,对比研究男性与女性、男性左右侧、女性左右侧肿瘤性质等相关指标的差异,并基于中医学和西医学理论对听神经瘤发病规律进行分析。结果 男性与女性听神经瘤患者在住院时间、肿瘤大小、肿瘤囊变方面比较,男性左侧与右侧听神经瘤患者在肿瘤囊变、术后感染脑膜炎、术后耳鸣缓解方面比较,以及女性左侧与右侧听神经瘤患者在年龄、住院时间、肿瘤大小、肿瘤囊变、肿瘤全切、术后脑脊液漏、术后面神经完整解剖保留方面比较,差异均具有统计学意义（P＜0.05）。结论 男左侧女右侧听神经瘤性质较良好,这与人体中男女、左右的阴阳气血升降差异有关。     

40例听神经瘤病人的脑干听觉诱发电位分析

目的:探讨听神经瘤患者的脑干听觉诱发电位(BAEP)变化规律及应用价值。方法:对听神经瘤患者作常规 BAEP 检查。结果:40例听神经瘤肿瘤侧 BAEP 异常率100%,非肿瘤侧 BAEP 异常率90%,以Ⅲ-Ⅴ间期延长尤显著(占90%),Ⅲ-Ⅴ/Ⅰ-Ⅲ比值异常占72%。结论:听力减退患者进行 BAEP 测试,对听神经瘤的诊断和鉴别诊断具有重要意义。     

听神经瘤的MRI诊断(20例报告)

回顾分析了20例22个听神经瘤的MRI表现。MRI检查采用0.35T超导MT/S成像系统,常规行冠状面T_1加权及横断面T_(1-)T_2加权成像。据瘤体大小将病灶分成4组,包括限于内听道者1例,1-2cm者2例,2.1-3cm者8例,大于3cm者11例,结果表明,T_1加权像对听神经瘤的诊断价值较大,主要依据是CP角内出现与听神经根部相连的肿块或听神经明显增粗;大于2cm的听神经瘤多可发生囊变、出血及脑干、Ⅳ脑室受压。除可发现位于内听道内的微小肿瘤外,MRI在肿瘤囊变、出血、周围结构受压情况、肿瘤供血血管及肿瘤与周围粘连情况的显示上均具有一定的优越性。     

伽玛刀治疗听神经瘤的临床疗效影响因素探讨

目的 分析探讨伽玛刀治疗听神经瘤的临床疗效影响因素.方法 回顾性分析2014年1月至2018年9月本院收治的76例听神经瘤患者的临床病历资料,比较听神经瘤患者流行病学临床特点.结果 听神经瘤患者中女性(57.89％)多于男性(42.11％);右侧患者占多数(65.79％);Koos分级中,Ⅱ级29例较多(38.16％)...