22例无症状性脑膜瘤临床诊治

Clinical features and treatment in patients with asymptomatic meningiomas： 22 cases reports

目的探讨无症状性脑膜瘤的临床特点和治疗。方法回顾总结1998-2006年22例无症状脑膜瘤患者的临床诊断治疗和随访资料。结果11例手术患者肿瘤都得到全切，未出现神经功能障碍，3例行立体定向放射治疗患者随访中未发现肿瘤增生。8例随访患者观察肿瘤生长缓慢，肿瘤最大径增长不超过1cm，最长随访（33个月）患者脑膜瘤由原来2cm增生至2．8cm。无症状脑膜瘤具有以下特点：（1）老年患者居多。（2）脑膜瘤一般较小。（3）脑膜瘤多发生于大脑凸面，且远离脑脊液通路和功能区。（4）首诊症状不典型，甚至无任何症状。（5）病理类型以内皮型、砂粒型、成纤维型等生长缓慢的为多。（6）影像学检查瘤周水肿不明显。结论若发现了无症状性脑膜瘤，并非需马上手术治疗，还要结合病人的具体情况，考虑年龄、肿瘤部位及大小、瘤周水肿等因素决定是否需手术治疗。

Objective to summarize the clinical features,diagnose and therapy for the patients with asymptomatic meningiomas. Methods We reviewed respectively the therapy and follow-up information of 22 patients whom diagnosed with asymptomatic meningiomas from 1998 to 2006. Results 11 patients accepted operation and the meningiomas were excised completely, without disable in nervous system. The other 3 cases accepted stereotactic radiotherapy and the tumors stopped hyperplasia in the follow up period, 8 cases were followed up from 6 to 33 months respectively. It was found that the tumor grew slowly in this period, The biggest growth was no more than lcm, A patient＇s tumor was hyperplasied from 2cm to 2.8cm in the longest 33 months follow up. The clinical features of this kind of patients including： （ 1 ） aged; （2） the meningiomas are generally smaller; （3）most of this kind meningiomas locate on the convexity of brain and away from the pathway of cerebrospinal fluid or the main domain; （4）the chief complaint is un-typical, even no chief complaint; （5） the tumors grow slowly and pathologic types including meningothellal Variants, psammomatous and fibroblastic etc; （6） the diagnostic images shows the edema around the tumor is light, Conclusions If the patient was diagnosed asymptomatic meningiomas, whether operation taken or not should consider several factors： the patient＇s physiclal status, age, the tumor＇s location and size, the edema around the tumor etc.