颅骨浆细胞瘤的诊治分析

Treatment experience of plasmacytoma of the skull

目的总结颅骨浆细胞瘤的病理、影像、治疗方案及预后。方法回顾性分析经手术及病理证实的14例颅骨浆细胞瘤患者的临床资料,并复习相关文献。结果颅骨浆细胞瘤血供丰富,术中易大量出血,其中全切4例,近全切5例,部分切除3例,活检2例。术后复发7例,死亡3例,失访4例。术后化疗10例,放疗3例。增强MRI均明显强化,MRI大多表现为等T1等或稍长T2,7例患者行CT检查,5例有骨质破坏。5例最终诊断为多发骨髓瘤。结论颅骨浆细胞瘤较为罕见,其中发生于颅底者尤甚。术前根据影像学检查往往难以确定诊断,确诊需根据病理学检查结果。不同类型的浆细胞瘤治疗方案不同,手术结合放疗或化疗是首选的治疗方案。

Objective To summarize the pathology,imaging,and diagnostic procedures of cranial plasmacytoma,with the aim of increasing awareness of the disease,increasing clinicians’understanding of the disease,and improving patient prognosis.Methods cranial plasmacytoma were retrospectively analyzed,and the relevant literature was reviewed.ResultsThe blood supply of intracranial plasmacytoma is abundant,and it is easy to bleed heavily during the operation.Among the cases collected in this group,4 cases were completely resected,5 cases were near total resected,3 case was partially resected,and 2 cases were biopsy.There were 7 recurrences and 4 deaths after the operation.Missed visits 4 cases.Ten cases received chemotherapy and 3 cases received radiotherapy.Enhanced MRI is significantly enhanced.MRI mostly shows equal T1 or slightly longer T2 signals.Seven patients underwent CT examination,5 patients had bone destruction.Five cases were finally diagnosed as multiple myeloma.ConclusionSkull plasmacytoma is relatively rare,especially in the skull base.It is often difficult to determine the diagnosis based on imaging examinations before surgery,and the diagnosis should be based on the results of pathological examinations.Different types of plasmacytoma have different treatment options.Surgery combined with radiotherapy or chemotherapy is the preferred treatment option.