脑肿块样脱髓鞘病变

Brain tumefactive demyelinating lesion

目的分析肿块样脱髓鞘病变的临床表现和影像学特点,以提高对肿块样脱髓鞘病变的认识。方法回顾性分析3例经病理证实的肿块样脱髓鞘病变的临床资料,并复习相关文献。结果3例患者术前均诊断为胶质瘤行手术治疗。术后均行激素治疗,其中1例症状好转,随访无复发,另两例症状一度好转,但最终因并发症肺部感染而死亡。结论肿块样脱髓鞘病变具有独特的临床表现和影像学特点。病变早期可采取内科激素治疗,病变发展至中晚期,旨在减压为目的的手术切除病灶是必要的。

Objective To study the clinical presentation and neuroimaging characteristics of tumefactive demyelinating lesion. Methods Three pathologically proven cases with tumefactive demyelinating lesion were retrospectively analyzed. Cases of tumefactive demyelinating lesion previously reported in literature were also summarized. Results All these three patients were misdiagnosed as glioma and operations were performed. Steroid therapy was followed. One patient was improved in clinical aspects and no recurrence. The other two patients were improved transiently but all died because of pulmonary infection. Conclusion Tumefactive demyelinating lesion has distinct clinical presentation and neuroimaging characteristics. Steroid therapy should be applied first. When patients develop late deterioration, it is necessary to remove the lesion surgically aim to decompression.