原发性腹膜后神经源性肿瘤93例分析

目的　探讨原发性腹膜后神经源性肿瘤的临床病理特征及外科治疗原则 ,以提高手术切除率及安全性。方法　回顾性分析 13年间经手术和病理证实的原发性腹膜后神经源性肿瘤患者的临床资料。结果　神经源性肿瘤占同期腹膜后肿瘤的 2 0 .6% (93 /4 5 2 ) ,其中神经鞘瘤 2 4例(2 5 .8% )、恶性神经鞘瘤 19例 (2 0 .4% )、副节瘤 14例 (15 .1% )、神经纤维瘤 16例 (17.2 % )、其他少见肿瘤 2 0例 (2 1.5 % )。术前CT和MRI检查的诊断率分别为 65 .6%和 73 .9%。手术切除率为97.9% (91/93 ) ,2例行探查活检。良、恶性肿瘤术后的 3 ,5年生存率分别为 95 .9% ,80 .1%和42 .4% ,10 .5 %。良性肿瘤术后复发 8例 ,复发率为 13 .1% ;恶性肿瘤复发 14例 ,复发率为 43 .8%。结论　CT和MRI对本病诊断有辅助意义 ;治疗首选手术切除。良性肿瘤预后良好 ,恶性肿瘤术后易复发

Primary retroperitoneal neurogenic tumor:analysis of 93 cases

Objective To explore the clinical and pathological characteristics and surgical treatment of primary retroperitoneal neurogenic tumor(PRNT). Methods 93 cases of PRNT were confirmed by operation and pathology from 1990 to 2003, and their clinical data were analyzed retrospectively. Results Primary neurogenic tumor accounted for 93 of 452 patients with primary retroperitoneal tumor in the same period. They included 24 cases of neurilemoma(25.8%), 19 cases of malignant neurilemoma(20.4%), 14 cases of chemodectoma(15.1%), 16 cases of neurofibroma(17.2%), and 20 cases of other rare tumors (21.5%) . The diagnostic rate of CT and MRI was 65.6% and 73.9%, respectively. In all but two patients the tumors were resectable. The resectability rate was 97.9%(91/93). The 3-year and 5-year survival rate in patients with benign and malignant tumors were 95.9%,80.1% and 42.4%,10.5%, respectively. There were 8 cases(13.1%) and 14 cases(43.8%) with recurrence after operation in benign and malignant tumors respectively. Conclusions CT and MRI are helpful in diagnosis. Surgical resection is the first choice of treatment. Prognosis in benign tumor is good, but postoperative recurrence of malignant tumor is frequent.