基础医学与临床 ›› 2015, Vol. 35 ›› Issue (8): 1106-1109.

• 临床园地 • 上一篇    下一篇

终丝室管膜肿瘤13例临床病例分析

姚玉强1,苏亦兵1,宫丽华1,王波2,乔京元1,丁宜1,赵继宗3   

  1. 1. 北京积水潭医院
    2. 中国科学院生物物理所
    3. 首都医科大学附属北京天坛医院
  • 收稿日期:2015-05-15 修回日期:2015-06-16 出版日期:2015-08-05 发布日期:2015-07-15
  • 通讯作者: 苏亦兵 E-mail:13801128287@139.com
  • 基金资助:
    国家自然科学基金;国家自然科学基金

A clinical report of 13 patients with filum terminale ependymal neoplasm

  • Received:2015-05-15 Revised:2015-06-16 Online:2015-08-05 Published:2015-07-15

摘要: 目的 探讨脊髓终丝室管膜肿瘤的临床特点、手术策略及预后分析。方法 回顾性分析了北京积水潭医院神经外科2009-2014年手术治疗的脊髓终丝室管膜肿瘤的临床特征、影像学资料、病理特征、手术资料及预后等。结果 13例患者病变最常见节段为T12~L3,长度1.5~11.0cm,平均4.1cm,有7例(54%)病理回报为黏液乳头型室管膜瘤(WHO I级),6例(46%)为室管膜瘤(WHO II级)。本组患者10例肿瘤全切除,3例大部切除。长期随访有2例复发,复发患者肿瘤均为分块大部切除,病理均为室管膜瘤(WHO II级),术后常规放疗。长期随访2例复发患者改良的Mccormick评级较术前分别下降1级和2级,余未复发患者有5例较术前提高1级或2级,余6例患者维持术前的1级或2级水平。结论 手术全切是终丝室管膜肿瘤最有效的治疗方法。

关键词: 终丝, 室管膜瘤, 黏液乳头型室管膜瘤, 病理学

Abstract: Objective To evaluate the clinical features, strategy of surgery, and prognosis of the patients with filum terminale ependymal neoplasm. Methods The clinical features, imaging findings, pathologic manifestation, operative details and prognosis of 13 patients with filum terminale ependymal neoplasm operated in the department of neurosurgery between 2009 and 2014 were retrospectively reviewed. Results The most common location of the tumor was in T12-L3, with the length between 1.5cm and 11 cm (average 4.1cm). Seven of 13 patients (54%) were reported as WHO grade I myxopapillary ependymoma, the other 6 patients (46%) were reported as WHO grade II ependymoma. Surgically gross total resection (GTR) was obtained in 10 patients without any recurrence in the follow up period. The subtotal resection (STR) was obtained in the other 3 patients, in which 2 patients with WHO grade II ependymoma relapsed in the follow up period although adjuvant radiotherapy was adopted post-operatively. Except these 2 relapsed patients, the modified Mccormick Scale of the other 11 patients improved at least 1 level or remained at the pre-operative levels. Conclusions Gross total resection (GTR) is the most efficient method for the ependymal neoplasms of filum terminale.

Key words: filum terminale, ependymoma, myxopapillary ependymoma, pathology