颅内血管外皮细胞瘤诊断和治疗

目的探讨分析颅内血管外皮瘤的诊断、治疗及预后。方法对1997-2006年间收治的18例颅内血管外皮细胞瘤就其临床和影像学表现、病理学特点、治疗及随访结果进行回顾性分析。结果18例病人共行手术23次,全切10例,次全切9例,部分切除4例。术后辅助传统放疗6例,辅助γ-刀治疗3例。15例原发病例中5例复发,平均复发时间76.75个月。发生颅内转移2例,发生神经系统外转移2例。结论颅内血管外皮细胞瘤不同于脑膜瘤,有较高的局部复发率,并可以发生神经轴和神经系统外转移,争取手术全切 剂量不少于50Gy的辅助放疗应作为常规的治疗方案。对于颅内血管外皮细胞瘤病人需终生随访。

Diagnosis and treatment of intracranial hemangiopericytoma

Objective To analysis and discuss the diagnosis,treatment and prognosis of intracranial hemangiopericytoma.Methods Between 1997 and 2006,18 patients with intracranial hemangiopericytoma were treated in our department,we analyzed the clinical and imaging presentation, pathological feature,treatment and follow-up results of these patients retropectively.Results Twenty-three operations were performed in 18 patients,total resection was achieved in 10 cases,subtotal resection in 9 cases and partial resection in 4 cases.6 cases received adjuvant conventional radiotherapy and 3 cases received adjuvant gamma knife treatment.The local recurrence rate in the 15 primary cases was 33.3%,the mean recurrence time is 76.75 months.Two patients developed intracranial metastases and two patients developed extraneural metastases.Conclusion Intracranial hemangiopericytoma is a rare turnout with biological behaviour totally different from mengioma,it have a high local recurrence rate and can metastasize in or outside the central nervous system.Complete resection followed by adjuvant radiotherapy of not less than 50Gy is a reasonable therapeutic strategy of the treament for the intracranial hemangiopericytoma. Lifetime follow-up is necessary because it might take many years to develop recurrence and metastases for such tumor.