延颈交界区室管膜瘤的显微外科治疗

目的总结延颈交界区室管膜瘤的诊疗经验。方法回顾性分析22例延颈交界区室管膜瘤病例的临床资料。经枕下后正中入路20例,远外侧入路2例。结果肿瘤全切除17例,近全切除4例,大部切除1例。病理诊断均为室管膜瘤,其中间变性室管膜瘤2例。随访22例,时间9~50个月,平均28.5个月。肿瘤复发3例,死亡2例,其余20例KPS评分80~100,平均92。结论显微神经外科手术是延颈交界区室管膜瘤的首选治疗方法,术中应争取全切肿瘤。对于未全切及间变性室管膜瘤病人术后应辅以放疗。

Microsurgical treatment of ependymoma in the medullocervical junction

Objective To summarize the diagnosis and treatment experiences of ependymoma in the medullocervical junction.Methods Clinical data of 22 patients with ependymoma in the medullocervical junction were analyzed retrospectively,including via suboccipital midline approach in 20 patients and far lateral approach in 2.Results Complete tumor resection was achieved in 17 cases,subtotal resection in 4 and partial resection in 1.All the patients were diagnosed as having ependymoma by postoperative pathological analysis,including 2 anaplastic ependymomas.Twenty-two patients were followed up for 9 to 50 months with a mean period of 28.5 months.Tumors recurred in 3 patients and 2 patients died of anaplastic ependymoma.The outcomes of the survival 20 patients were good and KPS scores ranged from 80 to 100 with a mean score of 92.Conclusions Microneurosurgery is the first choice of treatment for the ependymoma in the medullocervical junction and complete tumor resection should be achieved if possible.The patients whose tumors are subtotally removed or anaplastic should have adjuvant radiation therapy after operation.