目的 探讨胶质肉瘤的临床表现、影像学特征、病理特点、诊断及治疗.方法 收集2013 年1 月至2023 年1 月我院确诊为胶质肉瘤的9 例患者的临床资料进行分析,结合文献复习并总结.结果 6 例患者以颅内压增高为临床表现,1 例患者以局部神经功能障碍为临床表现,另 2 例癫痫发作入院.MRI提示均为幕上单发病灶,额叶 2 例,颞叶 5例,颞顶叶交界区1 例,枕叶1 例,病灶呈囊实性或实性病变,周围大片水肿带环绕,增强扫描可见强化,1 例患者病灶累及硬脑膜和颅骨.肿瘤全切7 例,部分切除2 例.患者术后病理均证实为胶质肉瘤.术后辅以放化疗6 例,放疗1 例,化疗1 例,1 例仅行手术治疗.患者平均存活12.4 个月.结论 胶质肉瘤是颅内罕见的高度恶性肿瘤,依据影像学检查和临床表现术前难以诊断,依靠病理结果确诊,手术切除仍为治疗首选,辅助以放化疗有助于改善预后.
Objective To analyze the clinical manifestations,imaging features,pathological features,diagnosis and treat-ment of gliosarcoma(GS).Methods From January 2013 to January 2023,clinical data of 9 patients with gliosarcoma confirmed in our hospital were analyzed,and relevant literature was reviewed.Results Intracranial pressure was increased in 6 patients,1 pa-tient presented with local neurological dysfunction,the other was admitted with seizure.Lesions in 9 patients were single by preop-erative MRI and above the tentorium,including 2 cases of frontal lobe,5 case of temporal lobe,1case of temporal parietal lobe,and 1 case of occipital lobe lesions which were with saccate solid lesions,obvious edema around tumors,signal enhancement scanning showed reinforcement,1 patient had lesions involving the dura and skull.In 7 cases total tumor resection and 2 case subtotal tumor resection were confirmed to be gliosarcoma by postoperative pathological examination.Postoperative adjuvant radiotherapy in 6 cases,postoperative radiotherapy in 1 case,postoperative chemotherapy in 1 case,and only surgery in 1 case.Patients survived an average of 12.4 months.Conclusion Gliosarcoma is a rare and highly malignant intracranial tumor.It is difficult to be diagnosed preoperative according to imaging examination and clinical manifestations.It is still the first choice to be diagnosed by pathological results.Surgical resection is still the first choice for treatment,and the adjuvant radiotherapy and chemotherapy is helpful to improve the prognosis.