颅内血管外膜细胞瘤颅外转移1例报告并文献复习

目的探讨颅内血管外膜细胞瘤和脑膜瘤颅外转移的危险因素和治疗及预后。方法报道我院2004年收治的1例颅内血管外膜细胞瘤颅外转移,并检索1987年至2004年的国外文献,对发生颅外转移的颅内血管外膜细胞瘤和脑膜瘤的病理类型、临床特征、治疗及预后进行临床分析。结果肿瘤恶性程度高、多次手术、不完全的手术切除、复发、侵及硬脑膜窦、肿瘤体积大,脑室内恶性肿瘤是发生颅外转移的危险因素。颅外转移灶可行手术切除。发生转移多预后不良。结论对于具有发生颅外转移危险因素的颅内血管外膜细胞瘤和脑膜瘤应注意排查转移灶;治疗中应避免可引起肿瘤通过血液和/或脑脊液转移的操作;原发病灶应尽量全切除,术后放疗;转移病灶可行手术切除,也可放疗和/或化疗。

A case report and review of the literature on intracranial hemengiopericytomas metastasizing

Objective To discuss the risk factors and prognosis concerning metastasizing hemangiopericytomas and meningioma.Methods One atient with metastases from hemangiopericytoma was reported and foreign and domestic literatures from 1987 to 2004 were reviewed.The histopathological pattern and clinical features,treatment and prognosis of metastasizing hemangiopericytomas and meningiomas were anlayzed.Results Histological malignancy,incomplete tumor resection,recurrence,vascular wall invasion and intraventrical malignant neuplasm were considered as the risk factors for the metastasizing of hemangiopericytomas and meningiomas.The metastasizing focus were removed if possible.The prognosis of metastasizing hemangiopericytomas and meningioma was poor.Conclusion For patients with metastasizing hemangiopericytomas and meningioma having several above risk factors the metastasizing focus should be considered; during the surgery the manipulation which can lead to spreading through blood and CSF should be avoided as much as possible; the original focus should be removed as completely as possible,the metastasis may be treated by surgery and radiotherapy or chemotherapy for better prognosis.