İntrakranial menenjioma olgularının değerlendirilmesi: 72 hastanın analizi
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Tarih
2018
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Dicle Üniversitesi Tıp Fakültesi
Erişim Hakkı
Attribution-NonCommercial 3.0 United States
info:eu-repo/semantics/closedAccess
info:eu-repo/semantics/closedAccess
Özet
Amaç: Kliniğimizde 2012–2018 yıllarında ameliyat olmuş ve menenjiom tanısı almış olan 72 hasta retrospektif olarak klinik, radyolojik ve patolojik bulgularıyla incelenerek literatür eşliğinde tartışıldı.
Yöntemler: Hastaların yaşları, cinsiyetleri, klinik bulguları, radyolojik görüntüleri, yerleşim yerleri, ameliyat kayıtları ve patolojik olarak aldıkları tanıları incelendi. Bulgular: 72 intrakranial menenjiomalı hastanın 47 (%65,3)’i kadın, 25 (%34,7)’i erkektir. Kadın/Erkek oranı: 1.88’dir. Olgular 19-78 yaş aralığında olup, yaş ortalaması 44.7’dir. Sıklık sırasına göre başvurma nedenleri ve nörolojik muayene bulguları: Baş ağrısı (%72,2), bulantı-kusma (%37,5), epilepsi (%25,0), motor defisit (%20,8)’dir. En sık yerleştikleri lokalizasyonlar: konvexite 17 (%23,7), parasagital 14 (%19,5), sfenoid kanat 9 (%12,59 bölgesidir.
Cerrahi tedavideki rezeksiyonumuzun Simpson klasifikasyonuna göre; hastaların 57 (%79,2)’i grade I, 8 (%11,1)’i grade II, 2 (%2,8)’i grade III, 4 (%5,5)’i grade IV ve 1 (%1,4)’i grade V olarak değerlendirilmiştir. Histopatojik tanıları ise sıklık sırasına göre; 29 (%40,3) meningotelyomatöz, 13 (%18,1) fibröz, 9 (%12,5) transisyonel, 6 (%8,3) oranında psammomatöz tip şeklinde tespit edildi. Sonuç: İntrakranial enenjiomalar malign tipleri dışında; genellikle benign karekterde yavaş büyüyen, erken tanı konup, total çıkarıldığında tam kür sağlanan, rekürrens oranı çok düşük olan tümörlerdir. Menenjiomalarda cerrahi kararın verilmesinde ve sürvide; hastaların yaşı, preoperatif performans skalası, tümörün lokalizasyonu, büyüklüğü, rezeksiyon derecesi, histopatolojik özellikleri gibi birçok faktör rol oynamaktadır. Asemptomatik, küçük boyutta, ameliyata uygun olmayan, yaşlı, kafa tabanı, kavernöz sinüs gibi ulaşılması zor lokalizasyonlarda bulunan hastalarda seri görüntülemelerle yakın takip ve radyocerrahi tercih edilebilir. MRG takibi 3. ay, 6. ay ve sonrasında yıllık takipler şeklinde ve takipte gerek görülürse, büyüme olursa cerrahi/radyocerrahi önerilir. Genç olan ve kalsifikasyonu bulunmayanlarda hızlı büyüme riski nedeniyle cerrahi düşünülmelidir.
Objective: 72 patients, operated and diagnosed as meningioma in our clinic, are discussed retrospectively with the clinical, radiological and histopathological findings in the enlightenment of literature. Methods: Patients' ages, sex, clinical findings, radiological images, tumors’ locations, operative records and histopathological diagnosis were reviewed. Results: Of 72 patients with intracranial meningioma, 47 (65.3%) were female and 25 (34.7%) were male. The female / male ratio is 1.88. The cases are between 19 and 78 years old and the average age is 44.7. Causes and neurological examination findings were as follows: Headache (72.2%), nausea and vomiting (37.5%), epilepsy (25.0%) and motor deficit (20.8%). The most common localizations were: convexity 17 (23.7%), parasagittal 14 (19.5%), sphenoid wing 9 (12.59%). According to Simpson classification of resection in surgical treatment; 57 (79,2%) patients were grade I, 8 (11.1%) were grade II, 2 (2.8%) were grade III, 4 (5.5%) were grade IV and 1 (%1.4) grade V .Histopathologic diagnoses are according to frequency; 29 (40.3%) meningothelial, 13 (18.1%) fibrous, 9 (12.5%) transitional and 6 (8.3%) psammomateous type were detected. Conclusion: Apart from malignant types of intracranial meningioma; usually benign tumors that grow slowly, when they are diagnosed early and removed totally are fully cured, and have very low recurrence rates. About deciding on surgery and estimating the survival rates the patient's age, preoperative performance scale, the tumor location, size, degree of resection, histopathological features and as many factors play roles. Close follow-up with serial imaging and radio surgery may be preferred for tumors which area symptomatic, small in size, or difficult to reach due to localizations like skull base or cavernous sinus, in elderly patients who are inappropriate for surgery. MRI follow-up is recommended at 3rd month, at 6th month, and afterwards annual follow-ups are recommended. Surgery should be considered in young patients and in those tumors without calcification because of the risk of rapid growth.
Objective: 72 patients, operated and diagnosed as meningioma in our clinic, are discussed retrospectively with the clinical, radiological and histopathological findings in the enlightenment of literature. Methods: Patients' ages, sex, clinical findings, radiological images, tumors’ locations, operative records and histopathological diagnosis were reviewed. Results: Of 72 patients with intracranial meningioma, 47 (65.3%) were female and 25 (34.7%) were male. The female / male ratio is 1.88. The cases are between 19 and 78 years old and the average age is 44.7. Causes and neurological examination findings were as follows: Headache (72.2%), nausea and vomiting (37.5%), epilepsy (25.0%) and motor deficit (20.8%). The most common localizations were: convexity 17 (23.7%), parasagittal 14 (19.5%), sphenoid wing 9 (12.59%). According to Simpson classification of resection in surgical treatment; 57 (79,2%) patients were grade I, 8 (11.1%) were grade II, 2 (2.8%) were grade III, 4 (5.5%) were grade IV and 1 (%1.4) grade V .Histopathologic diagnoses are according to frequency; 29 (40.3%) meningothelial, 13 (18.1%) fibrous, 9 (12.5%) transitional and 6 (8.3%) psammomateous type were detected. Conclusion: Apart from malignant types of intracranial meningioma; usually benign tumors that grow slowly, when they are diagnosed early and removed totally are fully cured, and have very low recurrence rates. About deciding on surgery and estimating the survival rates the patient's age, preoperative performance scale, the tumor location, size, degree of resection, histopathological features and as many factors play roles. Close follow-up with serial imaging and radio surgery may be preferred for tumors which area symptomatic, small in size, or difficult to reach due to localizations like skull base or cavernous sinus, in elderly patients who are inappropriate for surgery. MRI follow-up is recommended at 3rd month, at 6th month, and afterwards annual follow-ups are recommended. Surgery should be considered in young patients and in those tumors without calcification because of the risk of rapid growth.
Açıklama
Anahtar Kelimeler
Intrakranial menenjiomlar, Kranial cerrahi, Klinik çalışma, Radyocerrahi, Intracranial meningiomas, Cranial surgery, Clinical study, Radiosurgery
Kaynak
Dicle Tıp Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
45
Sayı
3
Künye
Turan, Y., Yılmaz, T. (2018). İntrakranial menenjioma olgularının değerlendirilmesi: 72 hastanın analizi. Dicle Tıp Dergisi. 45(3), 317-325
