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1、Spinalmeningioma（脊膜瘤）ZhangshuihuaNumber:P519199Gender:FAge:73yearsoldSymptom:backpainwithdoublelowerextremitiesmorethan10daysT1+CT1+CT2FSSpinalmeningiomaThespinalcordissurroundedbyaprotectivemembranecalledthemeninges,whichismadeupofthreelayers,theduram
2、ater,thearachnoidmembrane,andthepiamater.Tumorsthatarisefromthistissue,especiallythecellsthatmakeupthearachnoidmembrane(arachnoidcapcells),arecalledmeningiomas.RiskFactorsTheonlyprovenriskfactorinthedevelopmentofmeningiomaisexposuretoionisingradiation-
3、withtumourscommonlydevelopingfollowinga10to20yearlagtimefromexposure.Patientswithneurofibromatosistype2(geneticdefectonchromosome22)areatincreasedriskofdevelopingmeningioma.SymptomsThesymptomsofameningiomaarecausedbythepressurethegrowingtumorexertsonsu
4、rroundingtissue.Thesetumorscanoccurinavarietyofplacesandthereforecauseawiderangeofsymptoms.Dependingonthelocationofthemass,meningiomasmaycauseheadaches,nausea,seizures,weaknessornumbness(麻木)inthelimbsorface,visualproblems,andgradualchangesinmoodorperso
5、nality.Thesymptomstendtoincreaseinseverityasthetumorgrowsinsize.PrimarysitesandprimarypeopleMeningiomasaccountforapproximately25%ofspinalcanallesions.Theycanoccuratanylocationthroughoutthespine,butpredominateinthethoracicregion(probablybecausethisisthe
6、largestsegment).SpinalMeningiomasoccurapproximatelyfourtimesasofteninwomenasinmen,andtheaverageageis45years.ProgressionThistypeoftumourspreadsbylocalinvasionanderosionofsurroundingbonystructuresthroughpressureeffects.Meningiomasareveryrarelymalignantbu
7、toccasionallytumoursmayshowatendencytorecur.Summaryofthe2007WHOGradingSchemeforMeningiomasGradeI:Meningothelial,fibroblastic,transitional,angiomatous,microcystic,secretory,lymphoplasmacytic,metaplastic,psammomatous;doesnotfulfillcriteriaforgradeIIorIII
8、.GradeII(Atypical):Chordoid,clearcell;4ormoremitoticcellsper10hpfand/or3ormoreofthefollowing:increasedcellularity,smallcells,necrosis,prominentnucleoli,sheeting,and/orbraininvasioninanotherwisegradeItumor.GradeIII(Anaplastic):Papillary,
