颅盖骨孤立性浆细胞瘤一例并文献复习-论文.pdf

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1、·2895··个案报告·颅盖骨孤立性浆细胞瘤一例并文献复习焦风，刘波，梁冶矢【摘要】颅脑部位的孤立性浆细胞瘤只占髓外孤立性浆细胞瘤的极少部分，而颅盖骨的孤立性浆细胞瘤则更为罕见。本文分析了我院2010—11—18收治的1例颅盖骨孤立性浆细胞瘤患者的临床表现及治疗经过，并回顾相关文献对颅盖骨孤立性浆细胞瘤的临床特征及预后进行分析。本例患者为中年男性，主诉“枕部无痛性进行性增大肿物6个月”。CT及MRI检查提示枕骨溶骨性占位，硬膜及脑组织无受累。患者接受了病变切除加颅骨修补手术治疗，术后病理学证实为浆细胞瘤，全面检

2、查未见全身性骨髓瘤的证据。患者术后未进行放化疗，随访24个月肿瘤无局部复发但进展为多发性骨髓瘤。检索以往文献，共检索到54例有关颅盖骨孤立性浆细胞瘤的报道，其中52例(96．3％)患者进行了手术或手术+放疗，lO例(18．5％)患者转变为多发性骨髓瘤。研究结果提示颅盖骨孤立性浆细胞瘤通常预后良好，但少数病例常在疾病的某个阶段转变为多发性骨髓瘤而致病情恶化。目前推荐的治疗方案为根治性手术切除加放疗。【关键词】颅骨；浆细胞瘤；颅骨肿瘤；多发性骨髓瘤【中图分类号】R651．1【文献标识码】Ddoi：10．3969／j

3、．issn．1007—9572．2014．24．030焦风，刘波，梁冶矢．颅盖骨孤立性浆细胞瘤一例并文献复习[J]．中国全科医学，2014，17(24)：2895—2896，2900．[Vc'~／r~／．chinagp．net]SoHtaryPlasmacytomaoftheCalvaritma：ACaseReportandLiteratureReviewJIAOFeng，LIUBo，HANGYe—shi．DepartmentofNeurosurgery，PeopleSHospitalofPeking，Beij

4、ing100044，China【Abstract】Solitarycraniocerebrallocationistheleast~equentofalextramedullarysolitaryplasmacytomas．Solitaryplasmaeytomaofthecalvariumisevenmorerare．Weretrospectivelyanalyzedtheclinicalmanifestationandprognosisofamalepa—tientpresentedwithsolitary

5、plasmacytomaofthecalvariumandreviewedthecurrentrelatedliteratures．Thisisamiddle—agedmalepatientwhosehistorywaspainlesstumorofoccipitallocationfor6months．Computedtomography(CT)andmagneticreso—nanceimage(MRI)showedoccipitalnlasswithbonydestruction，buttheduraan

6、dbrainwerenotinvolved．Thepatientacceptedspreadsurgicalresectionandcranioplasty．Histologicalexaminationconfirmedplasmacytoma．Postoperativemyelomawork—upwasdone，theresultswerenorma1．Bonemarowaspirationshowednoevidenceofsystemicmyeloma．Thepatientdidnotreceiveth

7、eradiotherapyorchemotherapy．After24monthsfollowed—up，thetumorshowednolocalrecurrencebutunfortunatelyprogressedtomultiplemyeloma．Totally54caseswerereviewedofsolitaryplasmaeytomaofthecalvarium．52patients(96．3％)weretreatedwithsurgeryortogetherwithradiotherapy，b

8、utonly10patients(18．5％)transformedtomultiplemyeloma．Ourstudyshowedthatsolitarycalvarialplasmacytomashavegeneralygoodprognosis，whereasseveralpatientsinvariablyprogresstomultiplemye-lomaatsomestag