中枢神经细胞瘤的诊断和显微手术治疗

Diagnosis and microsurgical treatment of central neurocytoma

目的探讨中枢神经细胞瘤（CNC）诊断及治疗经验。方法回顾性分析16例CNC的诊断及显微手术治疗情况。采取纵裂-胼胝体-脑室入路5例，经皮质造瘘侧脑室入路9例，经枕下正中小脑蚓部入路1例，直接开颅切除1例。术后3例行放射治疗。结果术前误诊率62．5％。病理分级：WHOⅡ级7例，Ⅱ-Ⅲ级3例，Ⅲ级1例，未定级5例。病变全切除10例，次全切除4例，部分切除2例。除1例失访和1例复发外，其他病例恢复良好。结论CNC多数位于脑室系统，在影像学上有其特点。选择适当的手术入路行显微手术治疗预后良好。

Objective To explore the diagnosis and therapy experiences of central neurocytoma （CNC）. Methods The diagnosis and microsurgical treatment of the 16 CNC patients were analyzed retrospectively. A diastema-callosum-ventricle approach was adopted for microsurgery in 5 patients, cortex lateral ventriculostomy in 9, median suboccipital cerebellar vermis approach in one patient and direct craniotomy in one. The radiotherapy was implemented in 3 patients after the surgery. Results The preoperative misdiagnosis rate was 62.5%. In light of WHO classification, there were 7 cases with grade II, 3 with grad II -III, 1 with grade Ill and 5 undetermined. The total resection was achieved in 10 cases, subtotal in 4 and partial in 2. One patient lost to follow-up and one relapsed, the remaining recovered well. Conclusions CNC mostly locates in the ventricular system and has their own imaging characteristics. The prognosis of microsurgical treatment is favorable by choosing the appropriate surgical approach.