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| 題 名 | 多發性腦膜瘤 |
|---|---|
| 作 者 | 陳幸鴻; | 書刊名 | 中華民國外科醫學會雜誌 |
| 卷 期 | 21:1 1988.01[民77.01] |
| 頁 次 | 頁60-68 |
| 分類號 | 416.291 |
| 關鍵詞 | 多發性腦膜瘤; |
| 語 文 | 中文(Chinese) |
| 中文摘要 | 臺大醫院神經外料也1969年1月至1986年4月16年間手術的腦膜瘤共225例,其中有5例為多發性腦膜瘤,其發生率為2.2%。自從CT問世幫忙診斷之後,發生率有增加趨勢。5個病例都是女性;其中3例,其多發性腦膜瘤都發生在同一側顱腔內。病理組織上與一般常見的單發性腦膜瘤相似,無特殊之處;不過有1例異時性多發性腦膜瘤有低度惡性變形現象。對同時性腦膜瘤的外科治療,為了手術麻醉安全起見,有時須分兩次或多次進行;首先應先選擇引起神經症狀的腦膜瘤為目標進行切除手術,然後再安排另外的手術切除其餘共存的腦膜瘤;對高危險性的病人,則不必勉強冒險切除這些不引起症狀的腦膜瘤。多發性腦膜瘤的手術原則與一般的單一性者相同,以完全切除為理想,其復發率亦與單一性者相似,主要取決於切除徹底與否。多發性腦膜瘤的病因仍未有定論,但我們推測它可能是一種先天遺傳疾病,與von Recklinghausen's disease關係密切,或許卽其不完全型。 |
| 英文摘要 | From January, 1969 to April, 1986, there were 225 cases of intracranial meningiomas operated upon in the National Taiwan University Hospital. Among these, 5 cases of multiple meningiomas were found, with an incidence of 2.2%, which is comparable to the accepted incidence of 1-2%. There has been an increasing tendency of the incidence of multiple meningiomas since the advent of CT scan in our hospital in 1980. We also believe that with the help of CT, we will be able to diagnose more cases of synchronous multiple meningiomas that would otherwise be misinterpreted as heterochronous varieties because, without CT, the actually co-existing small or asymptomatic tumors may escape early detection at the same time with the main tumors. The average age of these 5 patients was 39.4 years which is younger than that in the group of single meningioma patients. Nevertheless it is difficult to draw a definite conclusion from a statistical point of view because of this small sample size. The 5 cases were all females and three of them had the tendency to hemicranial distribution. The tumors were benign histologically except for a suggestion of malignant transformation in one patient. Clinical features of multiple meningiomas in our cases are similar to those reported by other authors. The principle of surgical intervention for multiple meningiomas is not basically different from that for a single meningioma. The recurrence rate probably is mainly determinded by the radicality of tumor excision. For synchronous multiple meningiomas sometimes more than one operation may be needed to remove all the tumors for the sake of surgical safety. In such condition, the first operation should be arranged to remove the symptom-related main tumor and other accessible co-existing tumors. Only excision of the tumor causing the neurological signs and symptoms is recommended for elderly patients with medical problems. The remaining small, asymptomatic tumors can be in the out patients department regularly followed up: CSF dissemination and venous transmission were once proposed as the possible etiology of multiple meningiomas, but recently most people would rathet believe it is a forme fruste of von Recklinghausen's disease. |
本系統中英文摘要資訊取自各篇刊載內容。