颅内血管外皮细胞瘤的诊断和治疗

目的探讨颅内血管外皮细胞瘤的诊断治疗方法。方法回顾性分析自1993年1月至2004年6月华山医院神经外科收治的63例颅内血管外皮细胞瘤的临床表现、影像学表现、病理检查及治疗。结果63例患者中58例获得肿瘤全切除,5例行次全切除。手术后56例症状好转或不变,6例症状有所加重,1例术后死于并发症。术后获得随访38例,其中34例接受放射治疗,随访期为3～84个月,平均25个月。30例恢复良好,2例有远处转移（至腰骶椎）,6例肿瘤复发（均行再次手术,3例恢复尚可,2例有所加重,1例死于术后颅内感染等并发症）。结论颅内血管外皮细胞瘤是一类血供丰富的肿瘤,虽然生长较慢但是具有复发及转移的性质,因此手术应彻底切除肿瘤,术中应准备充足的血源,术前行部分供血动脉的栓塞对于减少术中出血、更安全地切除肿瘤有所帮助,同时辅以术后放射治疗以延缓复发,延长患者的生存期。

Diagnosis and treatment of intracranial hemangiopericytoma

Objective To summarize the experience in diagnosis and treatment of intracranial hemangiopericytoma (HPC). Methods The clinical data of 63 patients, 37 males and 26 females, aged 41 (14-77), with intracranial HPC were studied retrospectively. Results Fifty-eight patients underwent total excision of tumor and 5 patients underwent subtotal excision. Thirty-eight patients were followed up for 3 to 84 months (on average: 25 months), of which 34 underwent conventional external beam radiotherapy as an adjuvant measure after the first operation. Six patients who had local recurrence received second operation. Two patients had metastases to the spine. Conclusion Complete excision followed with radiotherapy can delay the recurrence of HPC, a malignant tumor with rich blood supply, and improve the prognosis. Pre-operative embolization of the feeding artery may be helpful to the surgery and abundant transfusion should be ready intra-operatively.