松果体实质细胞肿瘤的诊断与临床治疗分析

Diagnosis and treatment for pineal parenchymal cell tumors

目的探讨松果体实质细胞肿瘤的临床特点、诊断、治疗策略及预后。方法回顾性分析我院18例PPCTs的临床表现、影像特点及治疗和随访结果。结果手术后病理证实松果体细胞瘤6例,中间分化型松果体实质细胞肿瘤4例,松果体母细胞瘤8例。5例经Poppen入路,12例经穹窿间入路,1例经脑室三角区入路。肿瘤全切除3例,近全切除10例,大部切除3例,部分切除2例。无手术死亡,昏迷1例(2周后清醒),感染1例,复视1例,上视困难两周内改善3例。结论松果体实质细胞肿瘤是少见的颅内肿瘤,主要依靠病理诊断。此类疾病以手术治疗为主,联合化疗可能有助于提高生存期。

Objective To investigate the clinical features, diagnosis, therapeutic strategy and prognosis of pineal parenchymal cell tumors （PPCTs）. Methods A retrospective review of 18 patients with PPCTs diagnosed histopathologically was performed, and pertinent literatures were reviewed. Results Of the 18 PPCTs, total resection and sub-total resection were achieved in 3 and 10 cases respectively. Major part resection was obtained in 3 cases, part resection in 2 cases. Conclusions PPCTs are rare brain tumors. Due to difficulty in the preoperative diagnosis, a cautious preoperative diagnosis is required to select. Surgical resection is a safe and effective treatment for PPCTs. Regarding the poor prognosis of III - IV grade PPCTs, combined adjuvant chemotherapy and radiation therapy after operation can lead to prolonged remission.