侵犯颅底及颌面部骨巨细胞瘤(附三例报道)

目的 探讨侵犯颅底及颌面部骨巨细胞瘤的诊断与手术治疗. 方法 对川北医学院附属医院神经外科自2001年3月至2009年4月收治的3例侵犯颅底及颌面部骨巨细胞瘤患者的临床资料进行回顾性分析,总结该病的诊断要点、鉴别诊断及手术治疗体会.3例患者肿瘤均位于中颅窝底,向外侵及颌面部,临床症状以颅神经症状和面容改变为主.CT及MRI提示病变呈膨胀、破坏性生长.3例患者均行手术治疗,2例患者术后行放射治疗. 结果 3例患者术后效果良好,术后病理证实均为骨巨细胞瘤.随访中1例患者肿瘤复发但生长缓慢,另一例未见明显复发. 结论 侵犯颅底及颌面部骨巨细胞瘤的诊断可根据其生长特点、其引起的颅神经症状及影像学特征来做出判断.手术是其治疗的首选方式,术后是否放疗仍存在争议.

Operative therapy of giant cell tumor of bone invading base of skull and maxillofacial region (report of 3 cases)

Objective To explore the diagnosis and operative therapy of giant cell tumor of bone invading base of skull and maxillofacial region. Methods We retrospectively analyzed the clinical data of 3 patients with giant cell tunlor of bone invading base of skull and maxillofacial region and summarized the key to diagnosis,differential diagnosis and operative experience of this disease.The tumors were located at the bottom of the middle cranial fossa and outwards invaded the maxillofacial region with cranial nerve signs and alteration of facial features as their clinical symptoms.Dilatation and destructive growth in the pathological region was showed by CT and MRI.Operative therapy was performed in all of the 3 patients and radiation therapy was performed in 2 after the operative therapy.Results Improvement was achieved in 3 and the tumor was confirmed to be giant cell tumor of bone by pathology.Follow-up showed 1 recurrence with slow growth and 1 with no obvious recurrence.Conclusion The diagnosis of giant cell tumor of bone invading base of skull and maxillofacial region can be made through analyzing its growth characteristic, cranial nerve sign and its imaging features.Operation is the first option and radiotherapy is still under discussion for giant cell tumor of bone.