原发扣带回胶质瘤的显微外科治疗

Microsurgical management of primary cingulate gyrus gliomas

目的总结原发扣带回胶质瘤的临床特点、显微外科手术方法及疗效。方法回顾性分析2009年1月-2013年4月经手术治疗及病理证实的56例原发扣带回胶质瘤患者的临床资料。结果患者首发症状以癫痫为主。在电生理和B超辅助下,手术全切40例,近全切除11例;部分切除5例。病理结果星形细胞瘤34例,少枝胶质细胞瘤10例,间变星形细胞瘤5例,胶质母细胞瘤7例。82%肿瘤位于扣带回前部,18%肿瘤位于扣带回后部。结论扣带回胶质瘤是少见肿瘤,癫痫发作是其主要首发症状,显微外科手术切除是有效方法。术中电生理监测和术中B超是重要的辅助手段。

Objective To summarize the clinical features and microsurgical resection of gliomas in the cingulate gyrus（CG）. Methods Clinical data of 56 cases of gliomas in the GC were studied retrospectively. Results Complete resection was achieved in 40 patients, subtotal resection in 11 patients, and partial resection in 5 patients. Histologically, the tumors were astrocytoma in 34 cases, oligodendroglioma in 10 cases, anaplastic astrocytoma in 5 cases, and glioblastoma in 7 cases. Eighty- two percent of the gliomas were located in the anterior part of the CG and 18% in the posterior part.Conclusion Gliomas arising from the cingulate gyrus are rare. Seizures are the predominant presenting symptoms. Microsurgical resection is effective. Intraoperative monitoring and ultrasound are helpful ancillary approaches.