儿童脑膜瘤23例报告

Meningiomas in children:a report of 23 cases

目的 探讨儿童脑膜瘤的临床及病理特点。方法 笔者搜集 10年来经手术和病理证实的儿童脑膜瘤 2 3例 ,分析其临床表现、手术所见及病理特点 ,研究与成人脑膜瘤的不同之处。结果 2 3例中男 10例、女 13例 ,最常见的症状是颅内压增高和癫痫 ,平均病程 12 .5个月。其肿瘤部位 :2 0例位于幕上 ,2例骑跨左颅中窝和颅后窝 ,1例位于左桥小脑角。 11例直径达 7～ 10cm ,10例明显囊变 ,其中 5例呈大囊 +附壁瘤结节型。病理发现移行型 10例 ,纤维型 8例 ,合体细胞型 3例 ,血管瘤型 1例 ,非典型 1例。 8例纤维型中 6例直径在 7cm以上 ,7例明显囊变。手术全切 13例 ,占5 6 .5 % (13/2 3) ,次全切 6例 ,占 2 6 .0 % (6 /2 3)大部分切除 4例 ,占 17.0 % (4/2 3)。术后随访 17例 ,3例复发。结论 儿童脑膜瘤常见症状为颅内压增高和癫痫 ,病程较长 ,脑室内型较成人多见 ;具有巨大生长和囊变特点 ,影响手术全切 ;病理类型以移行型和纤维型多见 ,其中纤维型大多巨大且囊变 。

Objective To explore the clinical and pathological characteristics of meningiomas in children.Methods Twenty three cases (male 10,female 13,average course 12.5 months) of meningiomas were admitted in recent 10 years.The clinical presentations,surgical and pathological findings were analyzed and compared with those of the adults.Results The most common symptoms were increased intracranial pressure (ICP) and epilepsy.The tumors were located in the supratentorial (20),straddled left middle and posterior cranial fossa (2) and left cerebellopontine angle (1).The tumor size of 11 cases was 7～ 10?cm .Ten cases showed cystic degeneration.The pathological examination demonstrated transitional type in 10,fibrous type 8 and syncytial type 3.Thirteen cases ( 56.5% ) underwent complete tumor removal,6 subtotal removal ( 2.6% ) and 4 partial removal ( 1.7% ).Seventeen cases were followed up in which 3 recurred.Conclusions By the growth of meningiomas,it can cause an increase in ICP and epilepsy with relatively long course in children.The tendency to increase its mass and cystic degeneration make the exposure and total removal a challenge.Transitional and fibrous types constitute a common proportion of pathological findings,especially the fibrous type with large cystic degeneration may result in a high rate of recurrence of meningiomas.