Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantan Xili, Dongcheng District, Beijing, 100050, China.
J Neurooncol. 2014 Jan;116(1):99-106. doi: 10.1007/s11060-013-1256-6. Epub 2013 Sep 24.
Spinal cord subependymomas are very rare. Most studies on spinal cord subependymomas have been case reports with literature reviews. This study presented a surgical series of 13 patients with histologically proven spinal cord subependymomas. Their clinical data, radiological findings, operative records, and follow-up outcomes were reviewed. There were 5 male and 8 female patients with a mean age of 39.5 years. The mean follow-up period was 67.8 months. Four tumors were located in the cervical spine, 5 in the cervicothoracic spine, and 4 in the thoracic spine. Gross total resection (GTR) of the tumor with a well-demarcated dissection plane was achieved in 9 cases, and subtotal resection was achieved in 4 cases. The symptoms present before the surgery were improved in 11 cases at last follow-up and the current status of 2 patients had no change compared to the preoperative presentation at last follow-up. The postoperative follow-up magnetic resonance imaging showed no recurrence in the 9 GTR cases during the mean follow-up period of 70.3 months. No recurrence/regrowth of the residual tumors was observed in the 4 STR cases during the mean follow-up period of 62.0 months. Spinal cord subependymomas are amenable to surgical resection. It is possible to achieve GTR of intramedullary subependymomas that have a well-demarcated dissection plane. When GTR cannot be achieved, STR of the lesion for decompression is advised, and follow-up imaging is needed. A good clinical outcome after GTR or STR can be expected.
脊髓室管膜下瘤非常罕见。大多数关于脊髓室管膜下瘤的研究都是病例报告并附有文献复习。本研究报告了 13 例经组织学证实的脊髓室管膜下瘤患者的手术系列。回顾了他们的临床资料、影像学发现、手术记录和随访结果。男性 5 例,女性 8 例,平均年龄 39.5 岁。平均随访时间为 67.8 个月。4 个肿瘤位于颈椎,5 个位于颈胸段,4 个位于胸段。9 例肿瘤在有明显边界的层面上实现了肿瘤的全切除(GTR),4 例实现了次全切除。在最后一次随访时,11 例患者的术前症状得到改善,2 例患者的当前状况与最后一次随访时的术前表现相比没有变化。术后随访磁共振成像显示,9 例 GTR 中在平均随访 70.3 个月内无复发。4 例 STR 中在平均随访 62.0 个月内未见残留肿瘤的复发/生长。脊髓室管膜下瘤适合手术切除。有可能实现有明显边界的髓内室管膜下瘤的 GTR。当无法实现 GTR 时,建议对病变进行次全切除以减压,并需要进行随访影像学检查。可以预期 GTR 或 STR 后的良好临床结果。