显微手术治疗低龄儿童幕上脉络丛肿瘤

Clinical effectiveness of microsurgery for supratentorial choroid plexus tumors in pediatric patients under age of 6 years

目的总结6岁以下低龄儿童幕上脉络丛肿瘤的临床特点和手术经验。方法回顾性分析2004年1月至2010年12月显微手术治疗的13例6岁以下儿童脉络丛肿瘤患者的临床资料。本组13例,平均年龄为19.4月;肿瘤位于侧脑室7例、第三脑室内6例。结果肿瘤全切除10例,次全切除2例,部分切除1例。术后病理证实12例为脉络丛乳头状瘤,1例为脉络丛乳头状癌。术后随访3～92个月,平均38.1月;1例脉络丛乳头状癌患者术后6月复发并转移而死亡;1例脉络丛乳头状瘤患者术后16个月死于颅内感染;余11例存活。结论儿童幕上脉络丛肿瘤大部分为良性肿瘤,显微手术全切除肿瘤可达到满意的疗效。

Objective To report our experiences in treating supratentorial choroid plexus tumors （SCPTs） in pediatric patients under age of 6 years. Methods The clinical data of 13 consecutive patients with SCPTs （under age of 6 years; mean, 19.4 months） who underwent microsurgery from January 2006 to December 2010 were analyzed retrospectively. Results Six tumors located in the third ventricle, 6 in right lateral ventricle and 1 in left lateral ventricle. Total resection was achieved in 10 patients, subtotal in 2 and partial in 1. No patient died in the perioperative period. According to the 2007 WHO classification of turnouts of the central nervous system, 12 patients were classified as choroid plexus papillomas and 1 as choroid plexus carcinoma. The followed-up time ranged from 3 months to 92 months with a mean time of 38.1 months. Collapsed ventricle and subdural fluid collection occurred in 8 patients after operation. The patient with choroid plexus carcinoma recurred 6 months after operation and eventually died. One patient with choroid plexus papilloma died of intracranial infection 16 months after operation. Eleven patients with choroid plexus papilloma survived with no recurrence or progression at their last follow-up time. Conclusions Most SCPTs in children are benign. Total tumor removal by microsurgery can obtain good outcome in pediatric patients with SCPT.