16例视神经胶质瘤临床分析

目的探讨视神经胶质瘤(optic nerve glioma)的诊断、治疗和预后。方法对2003年至2007年收治的16例视神经胶质瘤患者的临床资料进行回顾性分析。结果16例患者中女性9例,男性7例;年龄2～53岁;视神经胶质瘤位于右侧8例,左侧4例,双侧4例;有视力下降者15例,视野缺损者12例;眼底改变者7例。伴头痛者4例;眼痛者2例;眼突者1例;颅压升高者2例;性早熟者1例。16例患者CT和MRI检查结果均显示阳性改变。16例患者均采取手术治疗,有3例术后辅以放疗。术后有8例失明,7例视力下降,1例死亡。病理诊断:视神经星形细胞瘤14例,视神经胶质母细胞瘤1例,1例未做病理学检查。结论视神经胶质瘤多见于10岁以下儿童,多为良性,有自限性;成年发病者多为恶性,可引起眼部及颅内不同症状和体征。宜采取综合治疗方法,如手术、放疗和化疗等。预后与肿瘤累及范围及性质有关。

Clinical Analysis of 16 Cases with Optic Nerve Glioma

Objective To explore the diagnosis,treatment and prognosis of the optic nerve glioma.Methods Sixteen cases with optic nerve glioma from 2003 to 2007 were collected and their clinical manifestations were summarized and analyzed.Results There were 9 females and 7 males;aged 2～53;8 right side,4 left side,4 bilateral;decline of visual acuity noted in 15;defects of visual field in 12;changes in ocular fundus in 7;headache in 4;ophthalmalgia in 2;exophthalmus in 1;intracranial hypertension in 2;sexual precocity in 1.All cases had positive results in CT and MRI.All cases had undergone operation.Three had postoperative irradiation.Eight cases resulted in blindness,death in 1 and decline of visual acuity in 7.Pathologic diagnosis:astrocytoma of optic nerve in 14,glioblastoma of optic nerve in 1,without pathologic diagnosis in 1.Conclusion Optic nerve glioma is often seen in children under 10,it is usually benign and self-limited.When occurs in adults,it is often malignant.It can cause varied symptoms and signs in eyes and intracranial complications.Comprehensive therapeutic methods should be adopted,including operation,radiotherapy and chemotherapy,etc.Prognosis is dependent on the range involved and the nature of the tumor.