恶性肿瘤颅骨转移11 例临床分析及文献复习.docVIP

恶性肿瘤颅骨转移11例临床分析及文献复习 王中玉* 史清明** 摘要： 目的 提高对颅骨转移瘤的诊疗的重视。方法 回顾性分析11例经细胞病理学证实的颅骨转移癌患者的临床资料。结果 颅盖骨转移10例，颅底骨转移1例，单发颅骨转移2例，多发颅骨转移9例；伴发头颅外其他部位骨转移9例。5例患者出现神经系统症状。11例中10例行ECT检查阳性，2例行CT及3例MRI检查见骨质破坏，1例行颅顶包块穿刺见腺癌细胞。分别给予化疗、放疗、双膦酸盐、手术、止痛、脱水等治疗头痛、呕吐、头昏等症状均控制，随访未再发生颅骨转移相关性骨相关事件及死亡。结论 颅骨转移应予临床重视。 关键词：骨转移；颅骨；恶性肿瘤 Clinical Study on 11 patients with skull metastasis and review of literature Wang Zhongyu, Shi Qingming 230022 Anhui Chest Hospital, Hefei China Abstract Objective To improve the attention to diagnosis and treatment of skull metastasis. Methods A series of 11 patients with skull metastasis were analysed retrospectively. All cases were confirmed by cytology and/or histological． Result There were 10 patients with calvarial metastases and 1 with skull base metastases. 2 were multiple osseous metastases and the rest were single. 9 patients had other sites of osseous metastases except the skull.5 patients had neural symptoms. ECT of 10 patients were positive .Computed tomography(CT) of 2 patients and magnetic resonance imaging (MRI) of 3 revealed bone destructions. The percutaneous needle biopsy of 1 patient revealed adenocarcinoma ? . ALL patients accepted one or more kinds of treatments , including chemotherapy, radiotherapy,,bisphosphonates, operation and so on.After these treatment all symptoms such as headache were controlled and no body had akeletal-related events or died of skull metastasis. Conclusion Calvarial metastases and multiple metastases are most common in skull metastasis.It usually occurres with other sites of osseous metastases.Skull metastases are usually asymptomatic but progress may cause neural symptoms.ECT/CT/MRI/ percutaneous needle biopsy can help the diagnosis and every one has superiority. The comprehensive treatment can significantly control symptoms and reduce the death associated with skull metastasis. Key words skull metastasis, comprehensive treatment,没写完 恶性肿瘤骨转移在临床上发生率较高，可累及脊柱、肋骨、骨盆、四肢骨、颅骨等，其中颅骨转移瘤较少见，约占10%，本文分析了我科2007年1月~2010年6月份收治的11例颅