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目的探讨恶性脑膜瘤的临床及病理学特点。方法结合文献,对29例恶性脑膜瘤患者的临床资料进行回顾性分析。结果29例包括脊索样型、非典型、乳头型、间变型脑膜瘤,占同期脑膜瘤的0.65%。本组均行显微外科手术,共32例次;SimpsonⅠ～Ⅱ级19例,Ⅲ级12例,Ⅳ级1例,随访25例(2～98个月,平均30.9个月),复发率为52%(其中SimpsonⅠ～Ⅱ级占46.2%),死亡率为36%;手术全切(SimpsonⅠ～Ⅱ级)+术后放疗者的复发率为27.3%,单纯手术全切复发率高达50%。结论同良性脑膜瘤相比,此病术前诊断有一定难度且预后差。就目前资料而言,手术全切尚不足以避免肿瘤复发,但可尽量减少肿瘤细胞数量,需再结合放疗以延缓肿瘤复发。
Objective To investigate the clinical and pathological features of malignant meningioma. Methods Combined with the literature, the clinical data of 29 patients with malignant meningioma were analyzed retrospectively. Results of 29 cases including the chordate type, atypical, papillary, anaplastic meningioma, accounting for 0.65% of meninges in the same period. This group of patients underwent microsurgery, a total of 32 cases; Simpson Ⅰ ~ Ⅱ grade in 19 cases, Ⅲ grade in 12 cases, Ⅳ grade in 1 case, followed up 25 cases (2 ~ 98 months, an average of 30.9 months), the recurrence rate 52% (including Simpson Ⅰ ~ Ⅱ grade 46.2%), the mortality rate was 36%; surgical resection (Simpson Ⅰ ~ Ⅱ grade) + postoperative radiotherapy, the recurrence rate was 27.3%, simple surgical resection recurrence rate as high as 50%. Conclusion Compared with benign meningiomas, the diagnosis of this disease has a certain degree of difficulty and the prognosis is poor. For the current information, the surgical resection is not enough to avoid tumor recurrence, but can minimize the number of tumor cells, combined with radiotherapy to delay tumor recurrence.