脊髓黏液乳头型室管膜瘤的诊断与治疗

Diagnosis and treatment of spinal myxopapillary ependymoma

目的探讨脊髓黏液乳头型室管膜瘤(spinal myxopapillary ependymoma,MPE)的诊断与治疗效果。方法回顾性分析9例脊髓MPE病人的临床资料,均经后正中入路手术切除肿瘤。结果肿瘤全切除8例;次全切除1例,术后行放射治疗。术后病理证实均为脊髓MPE (WHOⅠ级)。随访9例,时间3～60个月;1例出现局部转移,但无临床症状,继续随访;余8例病人无复发。结论脊髓MPE是临床少见的室管膜瘤类型,手术全切肿瘤是病人获得良好预后的主要因素,术中神经电生理监护和术中超声的运用可提高手术的安全性及全切率,无法全切的病人建议术后放疗。

Objective To explore the diagnosis and therapeutic effect of spinal myxopapillary ependymoma(MPE).Methods Clinical data of 9 spinal MPE patients were analyzed retrospectively,who received surgery via posterior median approach.Results Total removal of the tumors was achieved in 8 patients and subtotal removal in 1 patient who received radiotherapy after surgery.The pathological result was spinal MPE(WHO gradeⅠ).All the patients were followed up for 3 to 60 months,local metastasis was observed in 1 patient who had no clinical symptom and received continous follow-up.There was no relapse in the remaining 8 patients.Conclusions Spinal MPE is a rare type of ependymoma.Total removal of the tumor is the main important factor for a good prognosis.The safety and total resection rate can be improved by the application of intraoperative neuroelectrophysiological monitoring and intraoperative ultrasound.Postoperative radiotherapy is recommended to the subtotal removal of tumors.