脑膜瘤全切除术后复发的临床及病理类型分析

Clinical and histopathological features of recurrent meningiomas following total resection

目的：分析脑膜瘤全切除后复发的临床及病理学特点. 方法：选择第1次行肿瘤全切术的脑膜瘤复发病例31例,对复发时间、肿瘤病理类型及临床处理进行分析. 结果：本组31例复发脑膜瘤,其中25例复发1次,5例复发2次,1例复发3次.第1次手术切除的肿瘤病理类型包括WHOⅠ级15例(48%),Ⅱ级10例(32%),Ⅲ级6例(20%).第1次术后复发有26例行手术治疗,5例行立体定向放射治疗,复发时间平均为63个月,其中Ⅰ级脑膜瘤为76个月,Ⅱ级为65.8个月,Ⅲ级为33.7个月.复发后脑膜瘤病理类型保持相对稳定. 结论：脑膜瘤术后应密切随访,复发后应积极治疗.复发脑膜瘤组织学无恶变倾向,复发速度与肿瘤级别相关.

： Objectives:To investigate the clinical and histopa thological features of recurrent meningiomas following total resection. Methods: A retrospective study was performed to analyze a series of 31 r ecurrent meningiomas following total resection at the initial operation. The tim e of recurrence, histological subtypes and their clinical management. Results: Of the 31 patients with recurrent meningioma, 25 tumors displayed o ne recurrence, whereby 5 tumors displayed two recurrences and 1 tumor displayed three recurrences. The histological subtypes were classified as WHO gradeⅠin 1 5, gradeⅡ in 10,and gradeⅢ in 6. twenty six of the 31 patients had received re operation and other 5 patients received stereotactic radiosurgery. The mean time interval to the first recurrence was 63 months. Time to recurrence for WHOⅠ,Ⅱ andⅢwere 76, 65.8 and 33.7 months, respectively. Additionally, recurrent tumo rs may retain their original pathological appearance. Conclusions: Clinical and radiological follow up and monitor are needed for patients receivi ng operations for intracranial meningiomas. Recurrent tumors retain their origin al pathological appearance. The tumor grades significantly correlate with the in terval to recurrence.