位于颈3的上颈椎脊索瘤.pptVIP

Author：Liang Jiang作 者：姜亮  Orthopaedic Department, Peking University Third Hospital, 单 位：北医三院 当前1页，共28页，星期日。 Chordoma is a rare low-grade malignant neoplasm derived from the remnants of the embryonic notochord. This locally invasive neoplasm is subject to recurrence after treatment. The median survival time is estimated to be 6.3 years. 定义：脊索瘤是一种少见的起源于胚胎脊索残留组织的低分化恶性肿瘤。 特点：容易复发。统计学：中位生存期是6.3年。 Abstract 当前2页，共28页，星期日。 Various treatment approaches have been attempted, including radical excision, radiotherapy and chemotherapy. Treatment outcome is significantly influencedby the size and site of the chordoma. Recently, Imatinib, a molecular-targeted agent, has been shown to have antitumor activity in chordoma. Proton radiotherapy,stereotactic radiotherapy and intensity-modulatedradiotherapy have also been used. Surgical treatment is still the primary choice for chordoma. It has become more aggressive in recent years, evolving from intralesional or partial excision to en bloc resection. However, upper cervicallocalizations make such en bloc resection in most cases not possible.治疗进展：传统治疗包括根治性切除、放疗和化疗等。“Imatinib”的分子靶向治疗药物显示对于脊索瘤有治疗效果。光子放疗，stereotactic 放疗以及调强放疗亦应用于脊索瘤的治疗。外科治疗仍旧是脊索瘤的首选治疗方法。近一些年脊索瘤的外科治疗从瘤内刮除发展至部分切除直至全脊椎大块切除。然而，上颈椎独特的解剖位置使大块全脊椎切除治疗脊索瘤很难实现。 Abstract 当前3页，共28页，星期日。 We present and discuss the therapeuticchallenges of a young female with large retropharyngeal chordoma who presented to our institution after conventional photon beam radiotherapy. This C2/3 tumor was classified IB according to the Enneking classification. It distributed to layers A–D and sectors 1–6 according to the Weinstein Boriani Biagini Classification. The left vertebral artery (VA) was encapsulated and displaced. One stageintralesional extracapsular tumor excision and reconstruction was achieved by combined bilateral high anterior cervical approaches and posterior approach. No recurrence or metastasis was observed 3 years after the