鞍区畸胎瘤的诊断和治疗体会

The Prelimimary Experience of the Diagnosis,Treatment and Prognosis of 4 Sellar Teratomas

目的 :总结鞍区畸胎瘤的临床特点 ,探讨其诊断方法和外科治疗效果。方法 :收集 4例鞍区畸胎瘤的临床资料 ,其中成熟畸胎瘤 3例 ,恶性畸胎瘤 1例 ,4例患者皆行开颅手术 ,皆为近全切。全部诊断得到病理学证实。结果 :4例患者无一例手术死亡 ,严重手术并发症和复发。结论 :鞍区畸胎瘤术前不易诊断 ,肿瘤多与周围粘连是手术不能全切的主要原因 :保护下丘脑、视力是外科治疗的关键 ;熟悉鞍区畸胎瘤的影像学特点 ,全面的组织病理学检查、血清及脑脊液肿瘤标志物检测是诊断和治疗的重要依据。

Objective:To study the clinical characteristics,diagnosis and surgical treatment of sellar teratomas.Methods:Four patients,including three mature teratomas,one maglignant teratoma,were treated surgically and subtotally removed.Diagnosis was proved by histopathology.Results:There were no postoperative deaths,sever complications and recurrence occurred in all of the 4 patients.Conclusion:Diagnosis was difficult before operation.The main reason that sellar teratomas could not be totally removed was the teratomas often adhered to adjacent tissues.Protection of the hypothalamus and eye sight were the crucial points in surgical treatment.To be familiar with the characteristics of image,comprehensive histopathologic examination combined with serum and CSF tumors markers detection were necessary for correct diagnosis and treatment.