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題名 | Infratentorial Hemangioblastoma:Clinical, Radiological and Pathological Features=小腦天幕下血管母細胞瘤 |
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作者 | 施養性; | 書刊名 | 中華民國外科醫學會雜誌 |
卷期 | 18:1 1985.03[民74.03] |
頁次 | 頁71-79 |
分類號 | 416.291 |
關鍵詞 | 小腦; 血管母細胞瘤; |
語文 | 英文(English) |
中文摘要 | 血管母細胞瘤係神經組織微血管內皮細胞所衍生之良性腫瘤。通常呈現囊腫及其壁上之血管性結節;故其生態行為有相當的擴張性。基本上,這種良性腫瘤可以手術切除治癒。臨床表徵常常合併所謂von Hippel-L indau症候群以及血色素增高的現象。 榮民總醫院神經外科在過去6年6個月當中,共有1188個腦腫瘤病例。其中小腦天幕下血管母細胞瘤有19例,佔1.6%。年齡分佈從15歲至72歲,平均年齡為39.7歲。其中12例男性,7例女性。以外觀形態而言,15例具有囊腫,有-2例是多發性病灶。腦路電腦斷層攝影可以明顯看出囊腫病灶。而壁上血管性結節之正確位置及數目則有賴椎動脈血管攝影。 手術治療之原則為切除其血管性結節,若只處理囊腫則必然會復發。19例小腦天幕下血管母細胞瘤均接受手術切除血管性結節。有2例(11%)死亡。1例遺有四肢輕癱之後遺症。其餘16例(84%)均有良好之預後。正確的診斷及手術技巧可使此類病患得到治癒的結果。 |
英文摘要 | Hemangioblastoma is a histologically benign tumor which originates from the capillary of the neuraxis. It usually presents itself as a cystic tumor with a small vascular mural nodule which continuously secretes high protein fluid into the cyst. The biological behavior of hemangioblastoma is always expanding in nature. Basically, such a kind of lesion can be cured by surgical intervention. The association with the von Hippel-Lindau complex and that with erythrocytosis of the peripheral blood are two remarkable clinical features. In the past six and half years, we experienced 19 cases of infratentorial hemangioblastoma. There were 12 males and 7 females. The age ranged from 15 to 72 years with an average of 39.7 years. Among them, cystic lesions were found in 15 cases and solid lesions in 4 cases. The cystic lesions were found in the cerebellar hemisphere in 13 cases and in cerebellar vermis in 2 cases; and solid lesions located in the medul1a oblongata, cerebellar vermis and cerebellar hemisphere respectively. The majority of the cases, 17, revealed single lesion, while 2 cases exhibited multiple lesions. Computed Tomography (CT), which was usually the first step in our study, failed to demonstrate all the mural nodules; vertebral angiography, so far, has been the main tool to precisely show the mural nodule. Infratentorial hemangioblastoma has very high potentiality to be cured by surgical intervention. The most important procedure is total excision of the mural nodule, rather than drainage of the cystic fluid. |
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