儿童脑膜瘤的临床特点与误诊分析

Clinical Characteristics and Misdiagnostic Analyses of Meningiomas in Children

目的 分析儿童脑膜瘤的临床特点并探讨其误诊原因。方法 回顾性分析 2 4例年龄在 15岁以下的儿童脑膜瘤的临床资料 ,包括年龄、性别、临床表现、诊断、影像学与病理资料、治疗及随访情况。结果 2 4例儿童脑膜瘤 ,占同期收治的脑膜瘤总数的 2 .3%。其中 ,男 14例 ,女 10例 ,男女比例为 1.4∶ 1,平均年龄为 9.5岁。最常见的症状和体征为颅内压增高征 (6 6 .7% ) ,偏瘫 (33.3% ) ,癫痫 (33.3% )和颅神经损害 (2 9.2 % )。首诊考虑为脑瘤者 10例 (4 1.7% ) ,另14例误诊为其他病症 (5 8.3% )。全部病例均经 CT检查诊断为脑膜瘤 ,后经手术和病理证实。大多数脑膜瘤为良性肿瘤 ,但囊性和恶性脑膜瘤较成人多见。结论 儿童脑膜瘤发病率低 ,男多于女 ,肿瘤生长较快速 ,有恶变倾向 ,症状和体征在早期不典型 ,易误诊 ,临床上应加强对本病的认识。

Objective To investigaed the clinical characteristics and misdiagnostic reasons for childhood meningiomas.Methods 24 patients under 15 year of age with meningiomas were analyzed retrospectively with regaed to age,sex,clinical presentation,diagnosis,radiogical and pathological dindings,management and follow-up data.Results Thesr cases represented 2.3% of all meningioma cases during the study period.There were 14 males and 10 females(1 ratio of 1.4∶1)。The average age at presentation was 9.5 year.The most common presenting symptoms and signs were increased intracranial pressure (66.7%),motor deficit(33.3%),seizures(33.3%),and cranial nrever palsy(29.2%).10 cases were considered as brain tumors(41.7%)and 14 cases were misdiagnosed as other diseases(58.3%)at the initial diagnosis.All cases were diagnosed as meningiomas by CT scaning,operation and histopathological examination.Histologically,the majority of the tumors were benign,but cystic and malignant meningiomas were more common in children than those in adults.Conclusion Childhood meningiomas are uncommon and males are effected more than females.The tumors tend to groe more rapidly,undergo malignant changes,nonspecific symptoms and signs,and easy to misdiagnose at the initial stage of the disease.It′s important to enhance the knowledgement for this disease in clinic.