颅底黏液瘤的临床特点

目的提高对颅底黏液瘤临床特点及诊治方法的认识。方法回顾性分析经病理学证实的23例颅底黏液瘤病人的临床资料、影像学特点及治疗方法。对全部病人进行了手术治疗,对8例病人术后进行了放射治疗。对11例病人进行了随访,平均时间为64．5个月。结果颅底黏液瘤多位于鞍旁中颅窝底和颈静脉孔,临床表现为头痛及多组颅神经损害症状。影像表现出钙化或骨性成分位于肿瘤中心。手术入路根据肿瘤部位选择。次全切除16例,大部切除7例。术后临床症状好转2例;无变化11例;加重9例;死亡1例。随访结果：恢复正常生活6例;复发4例,死亡1例。结论颅底黏液瘤手术不易全切除,放疗效果不确定,黏液基质是肿瘤的实质部分。临床和影像方面不易与颅底软骨性肿瘤及脊索瘤鉴别。

Myxoma of cranial base: study of 23 cases

Objective To study the clinical manifestations and diagnosis and treatment of cranial base myxoma. Methods The clinical data of 23 cases of myxoma of cranial base confirmed by pathology from Oct.1983 to Nov.2005, 14 males and 9 females, aged 32.7 (18~50), were analyzed retrospectively. Operation was performed on all 23 patients, 8 cases underwent radiotherapy postoperatively. 11 patients were followed up after operation for 64.5 month. Results Most of the tumors were located in the parasellar and middle fossa and jugular region. The clinical manifestations included headache and injury of multiple cranial nerves. Imaging examination showed calcification and osseous elements in the center of tumor. The approaches of operation were selected according to the tumor position. Subtotal resection was achieved in 16 cases, and gross resection in 7 cases. The condition was improved postoperatively in 2 cases, unchanged in 11 cases, and aggravated in 9 cases, of which one died. The follow up showed that recuperation was achieved in 6 cases, recurrence occurred in 4 cases, and 1 patient died. Conclusion It is hard to remove the total myxoma of cranial base. The curative efficacy of radiotherapy is not definite. The important substance of the myxoma is mucus. It is difficult to differentiate myxoma from chondrogenic tumor and chordoma in cranial base by the clinical and neuroradiological manifestations.