摘要
目的 总结颅内恶性畸胎瘤的临床特点 ,探讨其诊断方法和外科治疗效果。方法 34例原发颅内恶性畸胎瘤均经手术切除和病理证实。根据患者的临床表现和神经影像学检查 ,确定肿瘤的生长方式 ;结合手术效果对临床资料进行回顾性分析。结果 34例中 ,有 6例术前诊断为畸胎瘤 ;行肿瘤全切除 14例 ,手术死亡率为 32 .4 %。 2 3例肿瘤呈侵袭性生长 ,其术后存活时间与非侵袭性生长者比较 ,差异有显著性 (P <0 .0 5 )。结论 颅内恶性畸胎瘤术前不易诊断 ,尤其是位于鞍区者 ;肿瘤的侵袭性生物学行为是手术治疗效果不良的主要原因 ;保护下丘脑、脑干功能和解除脑积水是外科治疗的关键 ;全面的组织病理学检查、血清及脑脊液肿瘤标志物检测是诊断和治疗的重要依据。
Objective To study the clinical characteristics, diagnosis and surgical treatment of malignant intracranial teratomas. Methods Thirty-four patients with intracranial teratoma proved by histopathology were treated by operation. The growth pattern of this tumor, assessed by its clinical manifestions and neuroimaging together with surgical treatment and results were analyzed retrospectively. Results Only 6 lesions had been correctly suspected as teratoma before surgery. Total removal was achieved in 14 patients with a operative mortality of 32.4%. The survival of 23 patients with lesions showing aggresive growth was significantly different from those without (P<0.05). Nineteen of these patients did not survive beyond the sixth month after surgery. Conclusion Accurate preoperative diagnosis is difficult in malignant intracranial teratoma, especially for patients with the tumor in the sella region. The invasive biological behavior of the tumor is proved to be the main cause of surgery being dwarfed. Protection of the hypothalamus and brainstem, relief of hydrocephalus are the crucial points in surgical treatment. Comprehensive histopathologic examnation combined with serum and CSF tumor marker detection is necessary for correct diagnosis and treatment.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2002年第6期595-598,共4页
Chinese Journal of Oncology
关键词
原发颅内恶性畸胎瘤
脑肿瘤
诊断
外科治疗
临床特点
Brain neoplasms/diagnosis
Brain neoplasms/surgery
Terotoma/diagnosis
Terotoma/surgery
