101例骶部肿瘤病理及临床表现分析

目的探讨骶部肿瘤的临床表现特点以及不同病理类型骶部肿瘤的特殊临床特点。为提高骶部肿瘤的初次诊断率、降低骶部肿瘤的误诊率提供依据。方法对1998年1月至2005年7月收治并进行手术切除的101例骶部肿瘤患者进行回顾性研究。平均年龄47.7岁(16～71岁)。女性43例,男性58例。其中脊索瘤、骨巨细胞瘤和神经源性肿瘤占61例(60.4%)。结果大部分骶部肿瘤最初临床表现为骶尾部疼痛伴或不伴假性/真性根性放射痛,随之发生腰骶神经感觉-运动障碍;膀胱、直肠和(或)性功能障碍表现则可贯穿在病程始终。不同病理类型的肿瘤临床表现有一定特征。结论脊索瘤、骨巨细胞瘤和神经源性肿瘤是主要的骶部肿瘤病理类型;骶部肿瘤临床表现有一定的共同特点;不同病理类型的骶部肿瘤临床表现具有一定差别,可为诊断和鉴别诊断提供一定帮助。

Pathologic and Clinical manifestation Analysis of tumors involving the sacrum(101 Cases)

Objective To explore the general and specific clinical manifestations and to improve the diagnosis rate of the tumors involving the sacrum with different histological background. Methods 101 patients with tumors involving the sacrum and underwent operations between January 1998 and July 2005 were review retrospectively and pathology and general manifestations were studied. Some specific manifestations of tumors with different pathological background were also reviewed. Results The most common pattern of neurological manifestation of tumor involving the sacrum was local pain with or without pseudoradicular or radicular lumbosacral irradiation and this was followed by lumbosacral sensorimotor deficit and finally by bladder and/or bowel and/or sexual dysfunction. Tumors with different pathological diagnosis show some specific manifestations. Conclusions Chordoma, giant cell tumor and neurogenic tumor are the main pathologic types of the tumors involving the sacrum. Tumors share some common manifestations though in general they lack specific presentation. Tumors with different pathologic background have some different clinical manifestations which helps in diagnosis and differential diagnosis.