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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 ,易于复发
Objective To investigate the clinical and pathological features of meningioma in children. Methods The author collected 23 cases of children with meningioma confirmed by surgery and pathology in 10 years, analyzed the clinical manifestations, surgical findings and pathological features, to study the differences with adult meningioma. Results Among 23 cases, 10 males and 13 females had the most common symptoms of intracranial hypertension and epilepsy with an average course of 12.5 months. The tumor site: 20 cases located in the screen, 2 cases riding across the left cranial fossa and posterior fossa, and 1 case located in the left cerebellopontine angle. 11 cases of diameter of 7 ~ 10cm, 10 cases of significant cystic change, of which 5 cases were large capsule + mural nodules. Pathological findings in 10 cases of migration, 8 cases of fibrous, syncytial cell type in 3 cases, 1 case of hemangioma, 1 case of atypical. Among the 8 cases of fibrous type, 6 cases were more than 7 cm in diameter and 7 cases were obviously cystic. The total resection was performed in 13 cases, accounting for 56.5% (13/2) of the total, 6 cases subtotally resected, accounting for 26.0% (6 of 23 cases). Most of the cases were resected in 4 cases (17.0%, 4/2 3). Follow up 17 cases, 3 cases of recurrence. Conclusions The common symptoms of meningiomas in children are intracranial pressure and epilepsy, longer course of disease, more common in adults than those in adults. They have the characteristics of huge growth and cystic degeneration, which affect the operation of total resection. The pathological types are more common in transitional type and fibrous type, Most of them are large and cystic fibrosis, easy to relapse