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患者男,38岁。因左额顶部胀痛4个月,加重伴恶心呕吐2周于1995年3月1日入院。检查:神志清楚,消瘦体型。左顶部骨缝明显分离,双侧视神经乳头明显水肿。脑神经、五官及心肺等未见异常。脑血管造影、CT及MRI检查提示左额顶部有一约16cm×6cm×6cm×6cm占位性病变。初步诊断为左额顶部恶性脑膜瘤。全麻下开颅探查。术中见左顶骨骨质破坏约3cm×3cm,脑压较高,肿瘤位于硬脑膜下,约16cm×6cm×6cm,黯红色,质地较硬,有包膜,血供不丰富,部分侵及软脑膜、脑组织。术中冰冻切片报告为恶性肿瘤。将全部肿瘤组织与所累及的颅骨、硬脑膜、部分脑组织一并切除。肿瘤重270g。病理诊断:左额顶部硬膜下横纹肌肉瘤。术后恢复良好,曾在外院行放疔,随访1年,无肿瘤复发征象。
Male patient, 38 years old. On the left frontal pain for 4 months, increased with nausea and vomiting for 2 weeks in March 1, 1995 admission. Check: Conscious, thin body type. Left the top of the suture was significantly separated, bilateral optic nerve head was significantly edema. Cerebral nerve, facial features and cardiopulmonary no abnormalities. Cerebral angiography, CT and MRI examination revealed a 16 cm × 6 cm × 6 cm × 6 cm space-occupying lesion at the top of the left frontal area. Initial diagnosis of the top left malignant meningioma. Craniotomy under general anesthesia. Surgery, see the left parietal bone destruction about 3cm × 3cm, high intracranial pressure, the tumor is located in the subdural, about 16cm × 6cm × 6cm, dark red, hard texture, enveloped, blood supply is not rich, some infiltration of soft Meningeal, brain tissue. Intraoperative frozen sections were reported as malignant tumors. The entire tumor tissue and the involved skull, dura, part of the brain tissue removed. Tumor weight 270g. Pathological diagnosis: the left frontal subdural rhabdomyosarcoma. After the operation, the patient recovered well and was discharged in the hospital. The patients were followed up for 1 year without signs of tumor recurrence.