椎管内钙化脊膜瘤1例并文献复习

Intraspinal Calcified Meningioma: A Case Report and Literature Review

摘要: 目的：报道1例椎管内钙化脊膜瘤患者病历资料，总结该病临床特点，为临床诊治提供参考依据。方法：回顾性分析我院收治的椎管内钙化脊膜瘤患者的病历资料，以“椎管内脊膜瘤”为关键词，检索并复习2000年1月至2021年12月中国知网数据库相关文献，汇总该类患者临床表现、影像学特征、病理资料及治疗特点。结果：共检索出文献277篇，筛选其中具有完整病例资料31例，本文报道1例，共32例进行汇总。其中男10例(31.25%)、女22例(68.75%)，男女比例约为1:2.2；年龄(47.59 ± 18.29)岁，年龄范围16~69岁；临床表现以下肢麻木无力、腰痛、胸痛为主；5例(15.6%)患者有高血压病病史，4例(12.5%)患者有糖尿病病史；32例(100%)患者均行MRI检查，病灶以胸椎管水平19例(59.4%)多发；32例(100%)患者均施行手术治疗，30例(93.8%)患者术后症状较术前有明显改善，术后病理以沙砾体型6例(18.8%)为主；误诊率达12.5% (4/32)；术后随访无复发。结论：椎管内脊膜瘤起病时间及持续时间无特征性，临床表现及早期征象不典型，误诊率高，早期诊断、治疗可改善患者预后且复发率低。

Abstract: Objective: This paper reports the medical records of a case of calcified spinal meningioma, summarizes the clinical characteristics of the disease, and provides reference for clinical diagnosis and treatment. Methods: The clinical data of patients with calcified spinal meningioma admitted to our hospital were retrospectively analyzed. With “spinal meningioma” as the key word, the relevant literatures of CNI database from January 2000 to December 2021 were retrieved and reviewed, and the clinical manifestations, imaging features, pathological data and treatment characteristics of these patients were summarized. Results: A total of 277 literatures were retrieved, among which 31 cases with complete case data were screened, 1 case was reported in this paper, and a total of 32 cases were summarized. There were 10 males (31.25%) and 22 females (68.75%), with a male to female ratio of 1:2.2. Age: (47.59 ± 18.29) years, age range: 16~69 years; the clinical manifestations were mainly lower limb numbness and weakness, lumbago and chest pain. 5 patients (15.6%) had history of hypertension, and 4 patients (12.5%) had history of diabetes. MRI examination was performed in all 32 patients (100%), and 19 patients (59.4%) had multiple lesions at thoracic canal level. All 32 patients (100%) received surgical treatment, 30 patients (93.8%) showed significant improvement in postoperative symptoms compared with preoperative symptoms, and 6 patients (18.8%) were mainly gravel body type. The misdiagnosis rate was 12.5% (4/32). Postoperative follow-up showed no recurrence. Conclusion: The onset time and duration of intraspinal meningioma are not characteristic, the clinical manifestations and early signs are not typical, the misdiagnosis rate is high, early diagnosis and treatment can improve the prognosis of patients, and the recurrence rate is low.