CAJ | 학술논문

目的探讨颅内原发恶性纤维组织细胞瘤(MFH)的诊断、治疗方法及预后.方法回顾2004年1月至2013年1月收治的7例颅内MFH患者的临床资料.其中男5例,女2例;年龄33 ～69岁.病变位于额叶4例,底节区1例,顶枕叶1例,枕叶1例.既往2例有颅脑放疗或伽玛刀治疗史,1例有颅脑外伤病史.CT显示2例明显钙化.MRI显示肿瘤大小约2～6 cm不等,多数肿瘤周围水肿明显,注药后呈结节样强化或不均匀强化.所有患者行开颅手术,术后4例行放疗.病理检查示4例恶性MFH,3例低度恶性MFH.结果术中发现脑内病变5例,基底位于硬膜的病变2例.肿瘤全切除5例,近全切除1例,大部切除1例.平均随访时间67个月,中位生存期15个月.3例因肿瘤复发死亡.更长的生存期倾向于与肿瘤全切除(P =0.057)、病理恶性程度低(P=0.075)有关.结论颅内MFH罕见,术前诊断困难,尚无特异的影像学诊断方法;治疗方法主要为手术治疗;但肿瘤复发率高,患者预后较差.
목적 탐토로내원발악성섬유조직세포류(MFH)적진단、치료방법급예후.방법 회고2004년1월지2013년1월수치적7례로내MFH환자적림상자료.기중남5례,녀2례;년령33 ～69세.병변위우액협4례,저절구1례,정침협1례,침협1례.기왕2례유로뇌방료혹가마도치료사,1례유로뇌외상병사.CT현시2례명현개화.MRI현시종류대소약2～6 cm불등,다수종류주위수종명현,주약후정결절양강화혹불균균강화.소유환자행개로수술,술후4례행방료.병리검사시4례악성MFH,3례저도악성MFH.결과 술중발현뇌내병변5례,기저위우경막적병변2례.종류전절제5례,근전절제1례,대부절제1례.평균수방시간67개월,중위생존기15개월.3례인종류복발사망.경장적생존기경향우여종류전절제(P =0.057)、병리악성정도저(P=0.075)유관.결론 로내MFH한견,술전진단곤난,상무특이적영상학진단방법;치료방법주요위수술치료;단종류복발솔고,환자예후교차.
Objective To study the clinical features and treatment strategy of intracranial malignant fibrous histiocytoma (MFH).Methods Between 2004 and 2013,there were 7 MFH patients who were surgically treated in Beijing Tiantan Hospital.There were 5 males and 2 females,aged 33 ～ 69 years old.The lesions located in frontal lobe (4 cases),basal ganglia (1 case),parietal-occipital lobe (1 case) and occipital lobe (1 case).The CT scan showed calcification in two cases.MRI revealed lesions to be 2 ～ 6 cm in diameter.Most of the tumors showed peripheral edema.After injection of Gd-DTPA,the tumors showed nodular homogenous or heterogenous enhancement.After surgery,4 patients received radiotherapy.The histopathology study showed 3 low-malignant and 4 malignant MFH.Results 5 cases were found to be intracerebral and 2 related to the meningial during the operation.Surgical resection was achieved GTR in 5 cases and STR in 2 cases.The mean follow-up time was 67 months.The median survival time was 15 months.3 patients died because of the tumor recurrence.The GTR of tumors and low pathological grade were tended to be related with longer survival time (P =0.057 and P =0.075,respectively).Conclusions The pre-operative diagnosis of intracranial MFH was difficult and lack of specific radiological features.Surgical resection was the most effective method for treatment.The prognosis of intracranial MFH was poor because of high recurrence rate.