胚胎发育不良性神经上皮肿瘤的外科治疗

摘要

Objective The surgical treatment for dysembryoplastie neuroepithelial tumors (DNET) was investigated.Methods A total of 12 cases (7 males,5 females,aged 4 ～36 years) of dysembryoplastie neuroepithelial tumors from June 2010 to June 2014 in Shanghai Blue Cross Brain Hospital were analyzed retrospectively,including 9 cases of temporal lobe,2 cases of frontal lobe,and 1 case of parietal lobe.The tumors and epileptogenic foci outside the lesions were resected under the guidance of electrocorticogram (ECoG) in all patients.Results The pathological examination showed that all the tumors were DNET.All the patients had been followed up for 2 to 4 years.The epilepsy seizure in 2 patients and the others were seizure free after the operation.No recurrence occurred in any patients during the follow-up.Conclusion DNET is a benign tumor which often produces intractable epilepsy,which can be controlled by the extended excision of the tumors and epileptogenic foci under the guidance of ECoG.%目的 探讨胚胎发育不良性神经上皮肿瘤(DNET)的临床治疗特点及效果.方法 回顾分析2010年6月至2014年6月手术治疗DNET患者12例,其中颞叶癫痫9例、额叶癫痫2例、顶叶癫痫1例;男7例,女5例,年龄4～36岁;手术方法采取在皮层及深部脑电监测(ECoG)辅助下行肿瘤及致痫灶扩大切除术.结果 所有患者术后病理均证实为DNET,所有患者术后随访2～4年,9例停药后癫痫发作消失,1例停药后仍有癫痫发作,2例仍在服药,癫痫无发作.MRI随访至少2年肿瘤无复发.结论 DNET是一种以顽固性癫痫发作为主要临床表现的良性肿瘤,手术效果良好,在术中脑电监测下行肿瘤加致痫灶扩大切除可获得良好的疗效.