Most tumors occur in the vestibular nerve of the auditory nerve. As the tumor grows larger, it compresses the lateral aspect of the pons and the anterior margin of the cerebellum, filling the cerebellopontine angle. Most of the tumors are unilateral, and a few are bilateral. This tumor is a benign disease, and even if it relapses multiple times, it does not occur malignant transformation and metastasis. The development sequence of typical symptoms of acoustic schwannoma: 1. At the beginning of the disease, there are symptoms of vestibular nerve and cochlear nerve damage such as dizziness, dizziness, tinnitus, and deafness. 2. The frontal occipital headache is accompanied by discomfort in the foramen magnum foramen. 3. Cerebellar ataxia and uncoordinated movements. 4. Symptoms of cranial nerve damage adjacent to the lesion, such as pain on the side of the lesion, decreased or disappeared facial sensation, facial convulsions, peripheral facial paralysis, etc., abnormal performance of the conduction beam. 5. Headache, nausea and vomiting, blurred vision and other symptoms of increased intracranial pressure, until the final stage of dysphagia, cerebral hernia crisis and breathing stopped. Clinical diagnosis According to the patient’s typical disease evolution and specific manifestations, the diagnosis is not difficult, but the problem lies in early diagnosis. It is best to make an accurate diagnosis when the vestibular nerve and cochlear nerve are damaged in the “otology” stage or when the tumor is limited to the internal auditory canal, so as to increase the total tumor resection rate, reduce the risk of surgery, and make the facial nerve and auditory nerve The function is retained to the greatest extent possible. Patients with the following symptoms in the early stage should consider the possibility of auditory schwannoma: 1, intermittent attacks or progressively worsened tinnitus. 2. Progressive hearing loss or sudden deafness. 3. Dizziness or temporary changes in posture appear when feeling unstable. 4. Intermittent tingling in the deep external auditory meatus or mastoid area. Hearing and vestibular function tests, as well as brainstem evoked potential tests, should be carried out to further clarify that diagnosis requires head CT and magnetic resonance examination. The prognostic effect of different treatment methods Surgery: The treatment of acoustic schwannoma is mainly treated by surgery. If it can be removed, it can often be cured permanently. Radiotherapy: Radiosurgery can be selected for patients with acoustic schwannoma who refuse, have a small size, and have mild clinical symptoms. Chemotherapy: Chemotherapy is ineffective.
Gynecological tumors can occur at any age, and the most common is 20-50 years old. Both internal and external female genitalia can grow, and the simplest in the external genitals are vaginal wall cysts. Internal genitalia such as uterine fibroids and various ovarian tumors. Because the uterus and ovary are located in the pelvic cavity, commonly known as “in the stomach”, it is impossible to directly touch it when it is invisible, and there is no symptom in the early stage, and there is no good method for early diagnosis and identification of good and evil. “Therefore, the nature of the preoperative judgment is not completely reliable. The following aspects suggest that you may have a gynecological tumor: a mass found in the abdomen, the growth rate can be different between fast and slow, generally speaking, malignant mass, benign slow, sometimes irregular vaginal bleeding or irregular menstruation, and adhesion to the surrounding organs, It is also a red flag and you should seek medical treatment as soon as possible. This is also not normal when feeling abdominal pain of various degrees and nature. Then there are more leucorrhea, and abnormal color and taste should be checked. Especially after the tumor grows to a certain size, it will affect its front and back “neighbors”, showing symptoms of large and small urine. The bladder is in front of the uterus. After compression, there may be frequent urination, urgency, and poor urination. The back of the uterus is close to the rectum, and the intestine is compressed by the tumor, and constipation may occur. Take a few examples to illustrate the common symptoms of ovarian tumors, such as lower abdominal discomfort after activity, often caused by the pedicles involving the tumor. Most benign tumors grow from one side from the bottom up, and malignant tumors can also have ascites in the early stage. When a large tumor oppresses the diaphragm, symptoms of dyspnea appear. Compression of the inferior vena cava can cause edema of the lower extremities. Sudden sudden abdominal pain, gynecological diseases are mostly benign tumor pedicle torsion, occasionally rupture, bleeding and infection. Malignant tumors are invading and growing, with abdominal, lower back, and leg pain. If the abdomen is clumped with chest and ascites, the three appear at the same time called the Mager’s sign, which is a manifestation of ovarian fibroids. Endocrine function tumors cause menstrual disorders.
Recently, a friend left a message under my article “I am a brain tumor discovered after going abroad… It is stage 2 of hemangioblastoma, but the doctor and my husband said that I can still live for 5 years. I am also strange that it is not a malignant tumor. Why do I say that I can only have 5 years?” The specific situation of this friend is far from enough to rely on current information, but with this opportunity, introduce two questions that many patients with brain tumors will ask after diagnosis: 1. Director Jia, can’t you do surgery? 2. Director Jia, how long can I live after surgery? In the treatment of brain tumors, surgery is the first choice. After all, most patients go to the hospital after symptoms appear (of course, except for some meningiomas, which are accidentally discovered). The reason why there are such treatment recommendations, in addition to the brain tumor itself The harm is also caused by tumor growth compressing peripheral nerves, causing increased intracranial pressure and so on. Of course, it is not absolute. Whether it needs surgery or depends on the specific situation of the tumor. For example, patients with prolactinous pituitary tumors are recommended for drug control, and patients with asymptomatic meningioma can observe and follow up! Simply put, the answer to “do not have surgery?” mainly depends on the specific situation of the patient. In general, if the doctor’s recommendation is surgery, it is best to cooperate with the doctor’s plan for treatment, after all, they are more professional. Besides, many patients and their families often ask “How long can I live after surgery?” Brain tumors include dozens of tumors, which cannot be generalized. According to the nature of tumors, they can be divided into benign tumors and malignant tumors. Different types of tumors have different survival times after surgery. Benign brain tumor refers to growth in a certain part of the skull (mostly outside the brain nerve tissue), the tissue is well differentiated, and the growth is slow. Clinically, most meningiomas, pituitary tumors, craniopharyngiomas, schwannomas, etc. are mostly benign tumors. If benign tumors can be scientifically treated (mainly surgery), the vast majority can achieve very good results, which can basically be cured without affecting the survival of patients. Most malignant tumors grow in brain nerve tissue, cells are poorly differentiated and grow rapidly. Common clinical malignant brain tumors include gliomas, tumors that have metastasized into the skull, etc. At present, the treatment effect of malignant tumors is often unsatisfactory, but clinicians still recommend that patients undergo surgery first, which provides a basis for the next treatment and improves the quality of life of patients! Of course, not absolutely! If there are important structures around the benign tumor, it is difficult to remove all the surgery and the prognosis may not be good if the discovery is too late; if the malignant tumor grows in a less important functional area, the surgery can be almost completely removed, and the patient can get better Prognosis! In addition to the nature of the tumor and the location of the tumor’s growth, the size of the tumor, the time of discovery, the patient’s physical condition, etc. all affect the patient’s survival time. It is normal for patients and their families to worry, but there is no need to worry too much. The most important thing for patients and their families to do is to maintain a positive attitude and cooperate with the treatment prescribed by the doctor!
Humans have long recognized the therapeutic effect of hyperthermia on diseases. In ancient times, ancient Greece, Egypt, China and other countries have recorded hot water baths for various diseases. “Book of Rites” in our country, “If you have a sore head, you can bathe. If you have an ulcer, you can take a bath.” “Yellow Emperor’s Internal Classic” also said: “It has evil spirits, and the stains are thought to be sweat, and evil can be dissolved with sweat.” Even before the invention of antibiotics, Hyperthermia is still a common method of treating various infectious diseases. In the field of malignant tumor treatment, hyperthermia also plays an important role. Ancient Chinese medicine practitioners used garlic-separated moxibustion to treat neck masses; ancient Western literature also documented the use of red hot irons to treat surface tumors. However, hyperthermia has really developed rapidly in recent decades. Recognizing that malignant tumors are a potential systemic disease, traditional treatments are powerless for deep and metastatic tumors, and people have been exploring safe and reliable tumor treatment options. After the 1980s, the United States and some European countries have successively developed experimental thermotherapy machines or thermotherapy equipment with relatively low toxicity and side effects and relatively reliable performance, which has made tumor hyperthermia in many countries (such as the United States, Germany, Japan, Mexico Etc.) can be applied. At present, a large number of experiments and clinical data show that although hyperthermia cannot replace surgery, chemotherapy or radiotherapy as an independent tumor treatment program, it has obvious synergistic and supplementary effects on tumor treatment methods such as chemotherapy, radiotherapy and surgery. Because of this, tumor hyperthermia has developed rapidly in recent years and has become another important tumor treatment method after surgery, radiotherapy, chemotherapy and biological therapy. It is deep hyperthermia and has the following effects on malignant tumors: 1. Promotes apoptosis and directly kills tumor cells; 2. Enhances the efficacy of chemotherapy; 3. Inhibits tumor blood vessel formation and metastasis tendency; 4. Enhances the body’s immune function; 5. Enhance the efficacy of radiotherapy; 6. Bone marrow protection; 7. Relieve cancer pain. Professor Li Dingfeng specifically pointed out that deep thermochemotherapy has its unique effect when used in cases where conventional methods are ineffective. Currently, deep hyperthermia is used in a wide range of cancer treatments, and the effect is good. According to reports, deep hyperthermia can be used not only for patients who relapse after initial treatment of tumors, patients who are resistant to chemotherapy or multi-drug resistance, and patients with malignant tumors that have widely metastasized or potentially extensively metastasized, but also can be used as adjuvant therapy for radiotherapy and chemotherapy, tumors Complementary treatment after surgery and palliative treatment of advanced malignant tumors. In addition, as far as hyperthermia itself is concerned, the appropriate treatment temperature (42°C or below) and treatment time will not cause adverse effects to patients with basically normal functions of the main organs of the whole body, and will not cause long-term damage to the human body. . From the current reports, deep hyperthermia is not effective for some cases of conventional treatment, the effective rate can reach 50%, the pain relief rate is about 50%, and does not increase the toxic and side effects of other treatments such as radiotherapy and chemotherapy. Of course, not all cancer patients are suitable for hyperthermia. For example, patients with severe organic heart disease, severe respiratory dysfunction, renal insufficiency, or patients who have not fully healed the incision after surgery are not suitable for this type of treatment. treatment. In summary, hyperthermia is a promising and proven effective treatment for advanced tumors. It can solve the pain of many patients with advanced tumors and is a worthy choice for patients with advanced tumors.
The incidence of gynecological tumors has been on an upward trend in recent years. The most obvious increases are ovarian cancer, cervical cancer and endometrial cancer, which have increased fourfold in 20 years. As the king of gynecological tumors, the incidence of uterine fibroids in adult women is as high as 40%. Many patients with gynecological malignant tumors are unable to detect and treat in time because of insufficient awareness of prevention. Gynecological tumors are only acquired by older women? Some people think that the tumor has nothing to do with themselves, it is the elderly. What is old? The aging degree of every organ of a person is different. For women, after 30 years of age, they are actually going downhill in all aspects. This is old, not menopausal menopause is old. The older you are, the greater the risk of getting a tumor. If you give birth too late, you will risk gynecological tumors. There was a survey of college girls. About 30%-40% of people had sexual experience. If she does not get married and have children within a few years after graduation, the chance of getting cervical cancer and other gynecological tumors will increase. Is cancer related to heredity? All cancers may be related to heredity. I often ask patients, does anyone in the family have cancer? The patient replied: “No.” I will ask grandpa and grandpa still there? Are the parents healthy? The patient replied: “Grandpa and grandpa died early.” How early? “They died when my mother was a child.” This family history may be problematic. Some people will say that grandma is breast cancer and uncle is lung cancer. How can I get cervical cancer. In fact, these are related. Cancer has a series of genetic genes that may behave differently in each person (showing lung cancer in this person and cervical cancer in that person). Is it necessary to check genes to predict cancer? There are some physical examinations that can do a lot of oncogene examinations. I don’t think it is necessary to do these things. Even if you have such a gene, you may not get cancer in the future. Why do you carry such a burden so early? After a good day, do what you should do, even if there is a problem in the future, there will be remedial measures. The more births, the lower the chance of getting a gynecological tumor? Some diseases are like this, such as endometrial cancer, women who are infertile are relatively more likely to get sick. Cervical cancer is easy to get for women who have more births or more people. Every year the unit has a physical examination, so there is no need to do gynecological examination, right? I think it is necessary to have a gynecological examination. Once there was a 28-year-old female patient who found an 18 cm uterine fibroids. She didn’t see the fluoroscopy in the unit physical examination the day before because the doctor did not check her uterus for lumps during the unit physical examination. When doing B-ultrasound examination of abdominal organs, there was no uterine attachment, so a large uterine fibroids was missed. Women’s gynecological cancer screening is very important. If you have conditions, you need to do a gynecological ultrasound. If you don’t have the conditions, you must touch the uterus and attachments at the surface to see if there are any lumps. What gynecological examinations do normal women do every year? It is enough for general gynecological examination, preferably once a year. If possible, make a systematic full-body examination. Women who have sex should do gynecological examinations whenever possible. How to prevent gynecological tumors in terms of living habits? With the promotion of disease screening, we have found more and more cancer patients. Many people feel panic because of this. Everyone is afraid that cancer is normal, but there is no need to talk about cancer discoloration. After all, cancer is a small probability event. The precancerous lesions and early lesions of most cancers can be detected and treated early (the early cure rate is more than 90%). For example, if a cervical test finds a positive HPV infection, the patient will be very nervous and feel that they have cervical cancer. In fact, not all HPV infections will cause cervical cancer. About 2% of people with high-risk HPV infection may develop precancerous lesions in the future. Precancerous lesions may not always develop into cervical cancer, and even if precancerous lesions develop into Cervical cancer also has a long process of 10-20 years, and there is no time for treatment within this period. Therefore, it is enough to check regularly and find the problem as soon as possible. The other is to avoid risks. Basically, gynecological diseases have a little advantage compared to other systems, that is, they give birth to children early. In case there is a gynecological malignant tumor in the future, as long as the uterus is cut, the problem will not be a problem. So giving birth to a child at a healthy age is also good for gynecological tumors
. . . In the diagnosis and treatment of bladder tumors, imaging examinations are indispensable, and X-ray imaging, ultrasound, computer-aided tomography (CT), magnetic resonance imaging (MRI) and other examinations are excellent. Disadvantages. 1. X-ray examination . . . .X-ray examination of urinary system includes abdominal plain film, venous urography, retrograde urography, antegrade urography, cystography, urethra, angiography and lymph Contrast examinations. In the imaging examination of bladder tumors, intravenous urography and cystography are commonly used. Angiography can be applied to the interventional treatment of advanced bladder tumors that cannot be surgically removed. With the increasing use of CT, MRI and other examinations, the importance of X-ray examination has declined. 2. Ultrasound examination Ultrasound examination is widely used in the diagnosis, differential diagnosis, and postoperative follow-up of bladder tumors because of its advantages of quickness, no damage, low price, and ability to be repeated. Transrectal ultrasound is a special probe inserted into the rectum. Through a series of scans, tumors in the posterior wall of the bladder, triangle, and neck can be clearly displayed. In particular, pedicle tumors near the neck can be clearly observed, and the seminal vesicles can also be explored at the same time. 1. The condition of the prostate. Transurethral ultrasound is to put an ultrasound probe into the urethra and probe after the bladder is full. Due to the need for cystoscopy at the same time, patients will feel pain and need anesthesia. Color Doppler (CDFI) can display the hemodynamic changes of bladder tumor blood vessels, including tumor blood flow richness, peak velocity, resistance index, etc., which can provide more information for clinical diagnosis.  . . . . It should be noted that the clinical application of ultrasound has many advantages, but the final diagnosis of bladder tumor still needs to rely on cystoscopy and pathological biopsy. Some patients with bladder tumors have small lesions or do not protrude from the mucosal surface, so for patients with obvious hematuria and no abnormalities on ultrasound examination, cystoscopy must be performed to exclude bladder tumors. 3. CT examination CT is an important method for diagnosing bladder tumors and determining the clinical stage of the tumor. CT scans can not only detect lesions, determine the location, size and number of lesions, show the extent of tumor involvement in the bladder, but also show the invasion of the bladder by the lesions. The degree shows whether the lesion has invaded the adjacent tissue and whether there is lymph node metastasis. Compared with cystoscopy, CT examination is less invasive and time-saving. For those who are contraindicated in cystoscopy, it can be used as a candidate examination. It can also show the invasion of the tumor outside the bladder, which is helpful for clinical treatment. Fourth, MRI examination . . . . In the diagnosis of bladder tumors, MRI and CT have their own characteristics. MRI has the advantages of no X-ray radiation, no gas and bony artifacts, many imaging parameters, multi-slice imaging, high resolution of soft tissue, and the ability to observe the characteristics of blood vessels without the need for contrast agents with the aid of the flow void effect, but it also has The shortcomings such as high price, long scanning time and interference of motion artifacts, its spatial resolution and anatomical details are inferior to CT. MRI is generally used in patients with contraindications (such as contrast media allergy and worry about radiation exposure) on CT scans.
The cancer has spread, but the patient’s meal is okay, the spirit is also very good, and the weight is also increasing, what is the matter? When reading this question, I can’t help but feel a bit strange. The advanced patients with cancer spread are often bedridden, with no blood on the face, and a skinny image. This is completely related to the appetite, spirit, and weight gain in the problem. So why do the same advanced cancer patients behave differently? There may be the following factors: 1. The course of the disease sooner or later is like an imaginary bed-ridden, cancer-free, skinny, skinny tumor patient is often some advanced patients with tumor cachexia, and they have entered the final journey of life. However, some patients who have just discovered tumor metastasis, or local metastasis to non-essential organs, may have a better early state. 2. The tumor is controlled. The tumor cells compete for the nutrients needed for normal human activity to grow and proliferate in the human body, and can cause some symptoms, such as pain, compression, and obstruction. If the primary cancer or metastasis is effectively controlled after active treatment and the symptoms improve, the patient can also show signs of improvement in the overall state. 3. The use of hormones The progress of cancer patients adopts some active treatment methods, such as chemotherapy, radiotherapy, targeted therapy, immunotherapy, etc. or may be accompanied by some toxic and side effects. The use of hormones to reduce the response. Hormone is a more common drug that can affect metabolism. It can cause disorders of water, sugar, lipid and protein metabolism in the body. In addition, those who often use the drug after hormone use will have a big appetite, such as eating a lot of high-sugar and high-fat foods will also cause weight gain. 4. The types of cancer: oral cancer, esophageal cancer, gastric cancer, liver cancer, these digestive tract tumors, because they can affect the patient’s eating and affect the absorption of nutrients, the absorption of nutrients is reduced and the tumor should not reduce the nutrients, but reduce the nutrition With the absorption of substances, cachexia develops to a certain degree. Tumors such as breast cancer, thyroid cancer, and prostate have a relatively good prognosis and a relatively long survival period. If they do not metastasize to important organs, they rarely show obvious consumption status. Some tumors such as lung cancer can secrete some hormones such as adrenal cortex hormones during the course of the disease, and antidiuretic hormones can cause water and sodium retention in the body, causing increased appetite and weight gain. 5. Edema or chest and ascites fluids are in fact appetite, spirit, and weight gain are not effective indicators for evaluating the patient’s condition. Although some tumor patients eat well, the high consumption status of the tumor is greater than the body’s intake of nutrients, and it has always been negatively balanced. Hypoproteinemia. Decreased albumin can cause water to accumulate in the body, which can lead to lower limb edema, chest tightness, wheezing, increased abdominal circumference, and bloating. In summary, appetite, meal size, weight, etc. are not indicators for effective evaluation, and other indicators such as imaging examination results, tumor indicators, etc. need to be considered comprehensively.
Many family members of patients take the patient’s discharge records and see a lot of puzzles when they see the diagnosis. It is normal for these professional terms not to be understood. A netizen asked: What does the poorly differentiated squamous cell carcinoma T1cN0M0 in the upper right lung mean? This is usually seen in the discharge diagnosis of lung cancer patients. This diagnosis summarizes the location of the disease, the type of cancer pathology, the degree of cancer cell differentiation, and the specific stage of cancer. The site of the disease is the upper right lung, the pathological type is squamous cell carcinoma, the degree of cancer cell differentiation is medium-low differentiation, and the specific TNM stage is T1cN0M0. TNM staging system for lung cancer is the most common tumor staging system in the world. The three letters TNM have their own meanings, T represents the size of the tumor and the degree of invasion of the surrounding tissues, N represents the metastasis of lymph nodes in the chest cavity, M represents the metastasis of distant organs in the whole body, including major organs, Bone and distant lymph nodes. After each letter, there are small numbers ranging from 0-4, T has 5 types from 0-4, N has 3 types from 0-2, and M has 2 types from 0-1. The numbers represent the severity of each letter. For example, N0 means that there is no obvious lymph node metastasis, N1 means the lymph nodes around the tumor, ipsilateral trachea or ipsilateral hilum and intra-pulmonary lymph node metastasis, M0 means there is no distant organ metastasis, If it is M1, it means there is a transfer. Different T, different N, different M, and the three are combined to form different stages I to IV. Lung cancer is classified into stages I, II, III, IV according to the TNM stage, and stage I includes stage IA and stage IB. T1 means that a lesion was found in the lungs and did not invade the visceral pleura. According to the diameter of the tumor, it is subdivided into T1a, T1b, and T1c stages. T1a means that the tumor diameter is less than or equal to 1cm, T1b means the tumor diameter is between 1cm and 2cm, and T1c means that the tumor diameter is between 2cm and 3cm. According to the different tumor sizes written above, corresponding to T1a, T1b, and T1c, lung cancer stage IA can be subdivided into IA1, IA2, and IA3. IA3 is T1cN0M0. From the point of differentiation, the low and medium differentiation is not very good, indicating that the degree of cell malignancy is high, and it is not as good as high differentiation. From the stage, IA stage belongs to very early lung cancer. Although IA3 is not the earliest lung cancer, it can usually be cured by radical surgical resection. With the development of minimally invasive techniques, lung segments are now used according to the location of the tumor, and even wedge-shaped resections are used to reduce trauma as much as possible without affecting postoperative lung function. Patients with stage IA generally do not need to do follow-up treatment after surgery. Regular follow-up review is sufficient. In short, the poorly differentiated squamous cell carcinoma T1cN0M0 in the upper right lung is a very early lung squamous cell carcinoma. It is highly likely to be cured by radical surgery, and there is no need for any treatment after surgery. Although the differentiation is not very good, as long as the surgery Norms generally do not affect the prognosis.
“Now the old man doesn’t have to worry about wherever he goes, he runs on his own…” Recently, a postoperative patient came to the clinic, and the family said happily. Who would have thought that this old man who can walk independently and be energetic by himself can only sit in a wheelchair a few months ago. Every time he goes out, he needs someone to take care of him, and the inability to walk brings great inconvenience to patients and family members. remembers the 66-year-old patient. Near the end of January, the patient, Grandpa Qin (pseudonym) came to our neurosurgery/spine and spinal clinic at the Northwest University Affiliated Hospital·Xi’an Third Hospital in a wheelchair. He was sad and was unable to walk at that time, and he had serious chest and back problems. Symptoms of pain. Grandpa Qin’s inability to walk was not sudden. He had numbness and weakness in his lower extremities for 8 months, and then he became unable to walk for about half a month. At first, it was not taken seriously. After the symptoms got worse, the family also took Grandpa Qin to many local hospitals, but they couldn’t solve the problem. They hoped to be extinguished again and again. Does Grandpa Qin remain in a wheelchair for the rest of his life ? The physical examination found that the muscle strength of both lower extremities was determined to be 3, and combined with imaging examination, Grandpa Qin was diagnosed as an extramedullary subdural schwannoma in T8 spinal canal, and surgery is recommended as soon as possible. Upon hearing the possibility of recovery, Grandpa Qin’s family rekindled hope and agreed to arrange surgery as soon as possible. Of course, the operation was very successful. The fine operation under the microscope perfectly peeled off the tumor and relieved the spinal cord compression in time. Grandpa Qin also recovered very well after surgery. After 5 days, he can walk in the corridor of the ward with the help of his family. I have been followed up after the operation. After 2 months, I have feedback that I can walk on crutches and take care of myself. I can even cook at home. And when we meet again this time, Grandpa Qin can already walk independently without the help of crutches, and he doesn’t have to follow his family when he goes out. Grandpa Qin was the happiest when he got rid of the wheelchair. He usually goes out to buy food and walks more freely. He can go on a trip with his friends and walk away without worrying about burdening his children. Postoperative video (5 days after surgery and 2 months after surgery) Grandpa Qin’s case is summarized as follows: Case 1 male, 66 years old. Chest and back pain, numbness of both lower limbs in August, can not walk for half a month. Pathological results: schwannoma in thoracic 8 spinal canal. In fact, patients like Grandpa Qin are not uncommon, but Grandpa Qin is lucky. After prompt surgery, the lower extremity symptoms are improved and they can stand up and walk again, but some patients are not so lucky. Therefore, early treatment and early treatment are directly related to the therapeutic effect of spinal canal tumors. Many people do not understand the disease of spinal canal tumors. The occurrence of low back pain does not take into account that it may be related to the tumors in the spinal canal. After the diagnosis of severe symptoms, the tumor will panic after hearing it. In fact, fear stems from the lack of understanding of tumors in the spinal canal, and the prevention, diagnosis, and symptoms of the disease are in a blank area. Next, we will focus on the related knowledge around the spinal canal tumor. 1. What is the disease of the tumor in the spinal canal? Intraspinal tumors refer to primary tumors or metastatic tumors that occur in the spinal cord itself and the tissues adjacent to the spinal cord (spinal nerve roots, dura mater, adipose tissue, blood vessels, congenital residual embryonic tissue, bone, etc.) Collectively. Most of them are benign tumors. Generally speaking, the only effective treatment at present is surgical resection. 2. What are the common tumors in the spinal canal? Intraspinal tumors can be divided into: epidural; extramedullary subdural; intramedullary tumors according to the relationship with the dura and spinal cord. A intramedullary tumor; B extramedullary subdural tumor; C epidural tumor meningioma, schwannoma and ependymoma account for about 90% of all spinal canal tumors. Epidemiological surveys in recent years have shown that about 0.74 to 1.5 people per 100,000 people per year are found to have one of these three tumors when doing MRI. According to reports, about two-thirds of spinal canal tumors are benign. ●Extramedullary tumors account for 42%-67% of intraspinal tumors, most of the tumors grow in the dura (85%), and the rest are exogenous. The most common extramedullary tumors are meningiomas (25-46%), schwannomas (33.9%), and terminal silk ependymomas (5.6-6.8%). ●Intramedullary tumors also have the three most common pathological types, namely ependymoma (30%-40%), astrocytoma (30%-35%) and hemangioblastoma (2%-15%) , Accounting for 90% of all intramedullary tumors
As the name suggests, skull base tumors are brain tumors that occur at the skull base and adjacent structures. Some tumors can develop from intracranial to extracranial or from extracranial to intracranial. Can grow through the skull base hole or after destroying the skull base bone. Skull base tumors are usually dominated by surgical treatment, and the location and characteristics of tumors diagnosed early are of great significance for the diagnosis and treatment of skull base tumors. Classification and clinical manifestations skull base tumors include anterior, middle and posterior skull base tumors and tumors in the rock slope area. Common meningioma, schwannoma, chondroma, chordoma, pituitary tumor, craniopharyngioma, vascular tumor and so on. Clinically, tumors invade the corresponding cranial nerve as the main manifestation. Common: decreased vision, double vision, loss of smell, hearing loss, tinnitus, facial paralysis, facial pain, unilateral limb weakness, epilepsy and other symptoms. Craniocerebral tumors are commonly examined by skull CT and MRI to determine the location of the tumor; angiography examination of skull base tumors with rich blood supply or close association with internal arteries such as internal carotid arteries should be performed with whole brain DSA or CTA examination to understand the main tumor blood supply Arteries and drainage veins, pay attention to whether the tumor encapsulates larger blood vessels; before the operation based on the skull base tumor site, visual field of vision, electrical audiometry and brainstem evoked potential examination. Craniocerebral tumor treatment methods The surgical methods of skull base tumors vary according to the location, size, nature, relationship with the surrounding structure of the tumor and the specific situation of the patient. The following basic principles should be followed: Using microsurgery techniques; Choose the most Good surgical approach and good exposure; Full protection of brain tissue, cranial nerves and important blood vessels at the base of the skull; Strive for total resection of tumors under the prerequisite of preserving important nerve functions, and at the same time must restore and reconstruct the normal physiological tightness of the skull base; For tumors that have not been completely resected, routine radiotherapy should be performed after surgery, or other treatments should be performed. Associate Professor Zhao Tianzhi, Department of Neurosurgery, Tangdu Hospital, reminded: follow-up follow-up follow-up after craniocerebral tumor surgery is required to prevent the tumor from returning! Why does it recur after surgery? First, the tumor is close to nerves and blood vessels cannot be completely removed: Some patients with brain tumors inevitably involve nerves and blood vessels. The clinical treatment of such patients can only be to remove the blood vessels and nerve functions while removing as much as possible, inevitable residual tumor. Residual oncologists generally recommend radiotherapy to avoid recurrence. However, there are very few tumors that grow near the nerves, blood vessels, or adhesions that are particularly important, and only a part of them can remain at this time. The remaining part may cause the brain tumor to recur again. Second, the tumor invasion of the skull is difficult to completely remove: For example: although meningioma is a benign tumor, some tumors in the clinic severely erode bone (invasive meningioma) surgery not only to remove the tumor, but also need to remove the affected bone (such as Erosion of the dura mater requires removal of the dura mater). However, even if it is so, it may be too close to the blood vessels and nerves, so it can not be completely removed, leaving a residue, resulting in recurrence. It should be reminded that most patients who have undergone surgical resection of benign brain tumors will not relapse. Of course, some patients have a special condition and relapse. However, after the relapse, the patient does not need to worry too much. The clinician will choose symptomatic treatment according to the patient’s condition, such as another operation. All patients have to do is to return to the hospital in time after relapse!
Preoperative data collection and analysis This is an important basis for judging the condition, estimation and prognosis of accountability. Preoperative imaging analysis is instructive in judging the extent and degree of resectable surgery. Preoperative imaging examination, MRI is very important. By carefully reading MRI and other examinations before surgery, focus on understanding whether there is arachnoid or pia mater around the tumor? What about the large blood vessels? Relationship with important structures around? This is of great significance for the surgeon to determine the surgical plan, the operation of key parts during the operation, and the overall strategy of intraoperative tumor resection. The design and main points of the surgical approach are difficult to expose because of the deep location of the skull base meningioma. In order to increase the exposure as much as possible without increasing the pulling of brain tissue, the design of the surgical approach must be as close as possible to the skull base lesion area. It may make the tumor base easy to expose, as far as possible by grinding the skull base bone and releasing cerebrospinal fluid to increase the exposure and operation space. Conditions can be used to assist navigation to determine the surgical approach. The satisfaction of the design of the surgical approach is the first step in the success of the surgery. The Osirix software mastered by Associate Professor Tianzhi Zhao in Neurosurgery of Tangdu Hospital can help doctors design the perfect surgical approach and treatment plan for patients. Tumor removal techniques 1. Bleeding control: Skull base meningioma generally receives double blood supply inside and outside the neck. The blood supply is rich, and the effective control and reduction of bleeding is a major problem to be faced by surgery. 2. The protection of important structures around the tumor: analysis of preoperative data, clear local anatomy and skilled microsurgery operation techniques and experience are the keys to reducing surgical injury. 3. The treatment of tumors covering important arteries: whether they can completely cut such tumors and protect the blood vessels is related to the degree of adhesion of the tumors to the wrapped arteries, whether they can accurately judge and dissect the arteries into and out of the tumor site, of course, it is also inseparable The carefulness and determination of the surgeon. General principles of surgical operation 1. When the technical and other conditions are not available, we should first maintain life and function, and do not consider the quality of life of the patient for tumor removal. 2. With the technical and other conditions, and the patient is basically fully equipped, the doctor must overcome the fear, and must consider both the patient’s short-term effect and its long-term effect. After all, it is most beneficial to the patient to completely remove the tumor while protecting the function. Moreover, the recovery of some neurological deficits that occur early after surgery is often better than we expected.
Chemotherapy is a routine treatment plan for most hematological and neoplastic diseases, such as acute leukemia, multiple myeloma, lymphoma, and myelodysplastic syndrome. Some patients will also be treated with oral chemotherapy. We need to be alert to a phenomenon-weight loss! Is it good or bad for patients with blood diseases to lose weight after chemotherapy? Different from the weight loss of healthy people, the weight loss caused by continuous chemotherapy is related to tumor disease, chemotherapy damage, emotional and psychological aspects, which is a bad phenomenon. Not only the external skin and muscle, but also the decline of internal organs and tissues and the corresponding organ dysfunction, but each has a bias: 1. Impaired gastrointestinal function affects digestion and excretion; 2. Impaired liver function affects liver detoxification and transaminase Abnormalities; 3. Impaired cardiopulmonary function affects blood and breathing; 4. Nervous system damage leads to numbness of skin and muscles or weakened gastrointestinal motility. The weight loss is caused by complex multi-factors, which also manifests various, overall dysfunctions, especially the significant weight loss during treatment, or should be considered as a bad signal for tumor survival and treatment. When the weight that directly reflects the physical condition is not optimistic, perhaps the physique has been seriously damaged, and the survival benefit of long-term treatment of blood tumors begins to decrease. People who are sensitive to chemotherapy toxicity and frail are more likely to experience sudden abnormal organ function after tumor- and chemotherapy-related weight loss, affecting comprehensive treatment. Therefore, it is necessary to protect in advance, find clues and adjust targeted treatment in time, and it is possible to obtain treatment opportunities and hope! If you have any questions about this article or the disease, please feel free to follow us on WeChat and search more: xyb56035035
With the high incidence and incidence of female diseases in modern society, more and more women have begun to learn to pay attention to their own health problems. For example, we often hear about female ovarian tumors. So, what are the causes of female ovarian tumors? What are the areas of daily life that require our vigilance and attention? Relevant medicine pointed out that under normal circumstances, ovarian tumors occur in menopausal women who have early menarche and menopause and are relatively young, because the incidence of these women will be relatively high. However, the risk of morbidity is greatly reduced for women who have a lot of births and who are breastfeeding and taking oral contraceptives. This kind of “continuous ovulation” clinical theory of carcinogenesis is also believed to be due to the damage of ovarian epithelial tissue cells caused by ovulation. Due to repeated damages, it promotes canceration during the repair process. This is also the reason for the body factor. In addition, there is a more researched cause in recent years, that is, genetic factors, the vast majority of cases are due to the dominant inheritance of chromosomes. For example, if one or two mothers or siblings have cancerous patients with this disease, the risk of developing malignant ovarian tumors in this generation is as high as 50%. What are the causes of ovarian tumors? We know that the above two causes are generally the cause of the formation of ovarian tumors. But in terms of the pathogenesis, it is the carcinogenic theory of this kind of patient’s “constant ovulation” and the genetic factors in the family, which has become a population of high-risk patients. Therefore, before the patient suffers from ovarian tumors, he must pay attention to prevent such diseases, for example, avoid eating high cholesterol foods in daily life. High-risk women’s contraception should take oral contraceptives for contraception. In addition, it is recommended that women over the age of 30 should have an annual gynecological examination. We must firmly believe in the principles of early detection and early treatment, because benign tumors will become malignant tumors after a period of growth, so early detection and detection of early symptoms of cancer are very conducive to the treatment of tumor diseases of.
Recently, I saw a news that a patient with a tumor in the spinal canal felt numbness and weakness in his feet three months ago. A CT examination in a local hospital was misdiagnosed as a lumbar disc herniation. The patient thought that he could play ball and go to work, and he did not care too much. Not long ago, I felt fatigue and pain in my feet, and I needed to walk on crutches, so I went to a local big hospital for medical treatment. After a physical examination by a doctor, when the patient soaked his feet a year ago, I noticed that my feet did not feel the temperature. He became agile, and his feet didn’t feel much of the hot hot water, and finally found a tumor in the spinal canal by a magnetic resonance imaging of the waist. Why do the editors have different results? In fact, there are many clinically similar cases. The first reason is that the incidence of tumors in the spinal canal is not as high as that of lumbar disc herniation, which is not well understood. Furthermore, there are many similarities between the symptoms of lumbar disc herniation and tumors in the spinal canal. The nerves of the waist are violated, causing pain in the waist, radiation pain in the legs, and numbness. The second reason is the examination. Although both CT and MRI are commonly used examination methods, the two are still very different. CT examination is fast and the bone structure is clear, but CT can not display the tumor in the spinal canal even if it is scanned; MRI The examination is time-consuming and shows that the soft tissue is clear, but when judging the disc disease and the intraductal tumor, MRI is more advantageous. Clinically, MRI is currently the most accurate imaging method for intraspinal tumor imaging. You should know more about lumbar disc herniation, but you don’t know much about tumors in the spinal canal because you usually hear less. So what are tumors in the spinal canal? Intraspinal tumors refer to the general term for primary tumors or metastatic tumors that occur in the spinal cord itself and in the spinal canal adjacent to nerve roots, dura mater, blood vessels, adipose tissue, congenital embryonic residual tissue, and other tissues. Intraspinal tumors are one of the common types of tumors in neurosurgery. Most of them are benign. According to statistics, the incidence rate is about 2.5 people per 100,000 people. The main harm caused by the tumor in the spinal canal is the compression of the spinal cord or nerve in the spinal canal as the tumor continues to grow. The main symptoms of patients with spinal canal tumors are nerve root pain, numbness of the limbs, dyskinesia, dysuria, and even paralysis. Editor . . When it is found out that the tumor in the spinal canal needs surgical treatment? Can the nerve function be restored after the operation? After the spinal cord and nerve are compressed, surgical intervention is required most of the time. However, many patients in clinical work have already experienced obvious compression, and the surgical indications are clear, but they are afraid of surgery, or think that drugs, physiotherapy, etc. can refuse surgery. What patients do not know is that after the spinal cord or nerve is compressed, if the spinal cord and nerve root are not decompressed in time, the compression will continue to increase, which may cause functional impairment. The damage to the spinal cord and nerves is irreversible. In other words, if the patient has limb paralysis and sensory disturbances due to nerve compression before surgery, even surgery can only ensure that nerve compression will not be further exacerbated, and whether damaged nerves can be recovered is not necessarily, limb paralysis and feeling Obstacles may not necessarily improve! Therefore, for most benign intraspinal tumors, it is generally recommended to operate as soon as possible after discovery, it is best not to procrastinate for too long.
The clinical manifestations of sphenoid crest meningiomas depend on the location of the tumor. The early symptoms of the medial type are obvious. Patients may have cranial nerve compression in the early stage, such as decreased vision, such as the invasion of the tumor into the orbit or supraorbital fissure, and obstruction of ocular veins. , Patients may have symptoms such as protruding eyeballs, and patients with medial type may also have symptoms of cerebral nerve damage in the first branch of Ⅱ, Ⅳ, Ⅵ, and Ⅴ. Mental symptoms and olfactory disorders are more common in tumors with anterior cranial fossa growth, but are rare Lateral sphenoid ridge meningioma symptoms appear late, only headache in the early stage and lack of localization signs, some patients can be manifested as temporal lobe epilepsy, such as tumor invasion of the temporal bone can occur zygomatic temporal bone bulge, tumor growth of the above two types of patients When it is larger, it will cause the muscle strength of the contralateral limb to decrease and the intracranial pressure to increase. CT can see a spherical growth tumor centered on the sphenoid crest, the boundary is clear, and the tumor shadow is obviously enhanced after contrast enhancement. For example, the tumor compresses the lateral fissure vein and the brain edema is more obvious. MRI is meaningful for the diagnosis of this disease. MRI can show the relationship between tumor and sphenoid wing and orbit, bone destruction, etc. Especially for the medial sphenoid crest meningiomas, MRI can also provide tumor and internal carotid artery Relationship, sometimes the tumor encapsulates the internal carotid artery, or the tumor is attached to the cavernous sinus. These conditions have important reference value for surgical resection of the tumor, and the enhanced MRI image is clearer. Cerebral angiography can provide the blood supply artery of the tumor, and the adjacent relationship between the tumor and the main blood vessels. The supply artery of the medial sphenoid crest meningioma mainly comes from the branch of the ocular artery. The internal arterial siphon bends, sometimes the internal carotid artery is directly invaded by the tumor, and the wall is irregular. The blood supply of the lateral sphenoid crest meningioma mainly comes from the external carotid artery branch, such as the middle meningeal artery, and a typical radial tumor appears. Blood vessels and tumor staining are more obvious in the venous phase than in the arterial phase. Due to tumor compression, the lateral cerebral image shows that the middle cerebral artery is generally elevated. At the same time of cerebral angiography, when the external carotid artery blood supply is seen, vascular embolism can be performed at the same time to make Surgery bleeding is reduced. Totally resected sphenoid ridge meningioma without compromising the patient’s nerve function is not easy. Medial meningiomas are particularly difficult because they may invade the cavernous sinus and internal carotid artery. Whether it is medial or lateral, the frontotemporal approach centered on the wing point is currently used. For tumors with a diameter greater than 2.0 cm, do not attempt to completely remove the tumor, so as not to damage important blood vessels and nerve tissue. Special care should be taken when separating the adhesion between the tumor and the middle cerebral artery. Any branch of the middle cerebral artery should be carefully separated from the tumor wall. If the separation is indeed difficult, the part of the tumor wall that is adhering to the artery can be left. Try not to damage the middle cerebral artery and its branches to avoid serious consequences after the operation. The deep part of the medial tumor is the internal carotid artery and optic nerve. In most cases, the tumor grows in a spherical shape, pushing the internal carotid artery inward. In a few cases, the internal carotid artery is wrapped by the tumor. In the former, there is a layer of arachnoid between the tumor and the internal carotid artery and optic nerve. Under the operating microscope, the tumor is removed within the capsule to expand the space of the surgical field, and then the tumor wall is pulled to one side, and the internal carotid artery and optic nerve can be found, carefully separated, and the tumor can be completely removed. If there are indeed difficulties, do not force it. However, if the tumor wraps the internal carotid artery, the internal carotid artery may narrow in a ring shape or even occlude. It is indeed difficult to remove the tumor around the intracranial artery. Tumors that invade the cavernous sinus have been completely removed in recent years. When separating tumors, care should be taken to identify and protect the Ⅲ, Ⅳ, and Ⅵ brain nerves. For bleeding of the cavernous sinus, absorbable gelatin sponge (gelatin sponge), hemostatic gauze, muscle and other materials can be used to compress the hemostatic.
Sphenoid crest meningiomas are meningiomas that originate from the large and small wings of the sphenoid bone. The inside rises from the front bed and the outside reaches the wing point. In early years, Cushing divided the sphenoid crest meningiomas into three parts: inner, middle and outer. In recent years, Watts suggested that this traditional positioning classification method be simplified into two types, namely the medial type and the lateral type. Most tumors are spherical and can grow in all directions. Sphenoid crest meningiomas can grow to the temporal, frontal, and frontotemporal junctions. Medial tumors can originate from the anterior bed process and invade into the orbital or supraorbital fissure. There are also rare tumors that grow to the anterior cranial fossa floor, causing corresponding clinical manifestations. Lateral sphenoid ridge meningiomas do not show symptoms early. Symptoms and signs: The clinical manifestations of sphenoid ridge meningioma depend on the location of the tumor. The early symptoms of the medial type are obvious, and the patient may exhibit cranial nerve compression early, such as decreased vision. If the tumor invades into the orbital fissure or supraorbital fissure, ocular venous return is blocked, the patient may have symptoms such as protruding eyeball. Patients with medial type may also have symptoms of nerve damage in the first branch of Ⅱ, Ⅳ, Ⅵ and Ⅴ. Mental symptoms and olfactory disorders are more common in those with tumors growing in the anterior cranial fossa, but are less common. Lateral sphenoid ridge meningioma symptoms appear late, only headache in the early stage and lack of localization signs. Some patients may present with temporal lobe epilepsy. If the tumor invades the temporal bone, zygomatic temporal bone bulge may appear. When the tumor growth of the above two types of patients is large, it will cause the contralateral limb muscle strength and intracranial pressure to increase. Prognosis: Lateral sphenoid ridge meningioma is not difficult to surgically remove, and postoperative recurrence and neurological damage are rare. There are many difficulties in complete resection of medial meningiomas, and there may be Ⅲ, Ⅳ, and Ⅵ cerebral nerve function damage after operation. Another patient may have limb movement disorder and motor aphasia after surgery. For patients with medial type that have not been completely resected, postoperative radiotherapy may be used to prevent recurrence. If the tumor recurs, consider surgical resection again. Left sphenoid crest and parasaddle meningiomas Associate Professor Zhao Tianzhi recently performed a surgical treatment for a patient with a left side sphenoid crest and parasellar meningiomas. It has been recovered for more than two months after surgery. Mr. Zhang’s dizziness, aggravation of left visual acuity, accompanied by left side numbness, pain, slurred speech, slowness and other symptoms. After CT imaging examination, he was informed of the left sphenoid crest and parasaddle lesions. Associate Professor Zhao Tianzhi introduced: The patient’s left eyelid lift is severely restricted. In popular terms, one eye is larger than the other, and the left vision is significantly reduced. The results of the head MRI showed that the left middle and posterior cranial fossa was riding a huge tumor with a maximum diameter of more than 7 cm. At the same time, the tumor surrounded the left internal carotid artery, middle cerebral artery, posterior communicating artery and many small wearers The branch artery, the left frontotemporal brain tissue and the optic nerve are severely compressed, and protrude downward into the posterior fossa of the posterior cranial fossa. The operation is difficult and the risk is high. For such a complex huge intracranial tumor, how to completely remove the intraoperative and protect the normal intracranial tissue is the key to the operation, then, how to separate and retain the blood vessels, oculomotor nerve, optic nerve, pituitary stalk, etc. Structure, how to reduce the surgical risk is the key, use Osirix software to perform three-dimensional preoperative evaluation before surgery, clarify the surgical plan, and reduce the surgical risk.
Tumor does not want to amputate? Are there any other treatment options? Recently, the editor interviewed Dr. Li Dingfeng, the former Cancer Hospital of the Chinese Academy of Medical Sciences. He pointed out that subcutaneously implanted arterial chemotherapy can increase the concentration of chemotherapy drugs, reduce toxic and side effects, and provide the possibility for tumor patients to preserve organs, limbs and functions. Professor Li Dingfeng, the former expert of the Cancer Hospital of the Chinese Academy of Medical Sciences and the chief physician of the Cancer Center of Xiangya Boai Hospital, introduced that for solid tumors, the standard treatment mode of chemotherapy, surgery, and re-chemotherapy should be followed. Chemotherapy before surgery can effectively kill satellite foci around tumors and subclinical foci of distant metastasis. The primary foci of tumors can be reduced by chemotherapy, and clear surgical boundaries can create conditions for surgery. Preoperative neoadjuvant chemotherapy: the primary focus can be reduced and the tumor boundary is clear, creating conditions for surgical operations. Subcutaneous implantable arterial chemotherapy technology provides the possibility of subcutaneous implantable arterial chemotherapy for organ preservation, limb preservation, and function preservation: will The chemotherapeutic device is buried under the skin near the tumor, and the drug delivery catheter is introduced into the artery that supplies blood to the tumor tissue. The size of this chemotherapeutic device is not large. After being buried in the human body, it has basically no effect on the normal activities of the person before and after the surgery for a long time. When the medicine needs to be administered, the medical staff can simply use a common syringe to push the medicine into the chemotherapeutic device. According to the condition, the medicine can be administered at any time or for a long time, which is simple and convenient. Because the chemotherapeutic drugs are produced by the chemotherapeutic device and reach the tumor tissue, the degradation of the liver and kidney before the tumor reaches the tumor is avoided, and the drug concentration in the tumor area is increased, and each time it is doubled, the therapeutic effect can be increased by 10-20 times. In this way, not only can the drug effect be fully exerted, but also the toxic side effects of the drug on the human body are reduced. Then, in response to the problem of strong repair ability of tumor cells in the past, an anti-repair agent was administered through a chemotherapeutic device to inhibit the repair of tumor cells and further improve the killing effect of chemotherapy drugs on tumor cells. Another advantage of using this chemotherapy method is the short course of treatment. It is clinically proven that the effect of one course of chemotherapy is equivalent to the effect of 2-3 courses of ordinary chemotherapy. More importantly, in the process of applying this method, some soft tissue tumors that are not sensitive to traditional chemotherapy methods, such as liposarcoma, alveolar rhabdomyosarcoma, and synovial sarcoma, etc., can be completely treated by this method. Killing tumor cells is extremely beneficial for retaining patients’ limbs. Limb salvage treatment for osteosarcoma with obvious pathological fractures 29-year-old osteosarcoma with obvious pathological fractures Osteosarcoma with salvage pathology Treatment of skin dermal fibrosarcoma soft tissue sarcoma sarcoma and cancerous ulcers The technique of “subcutaneous implantable arterial guided chemotherapy” in the right forearm soft tissue deficiency group, due to the greatly increased drug concentration and duration of drug efficacy, enhances the treatment of tumor cells Killing effect, while increasing the repair agent caffeine after tumor chemotherapy, so it has obvious advantages in the treatment of bone and soft tissue tumors, such as pro-apoptosis, anti-repair, and maximum avoidance of amputation. In addition, it also has bone metastasis cancer, Primary tumors, such as pelvic malignant tumors, lung cancer, breast cancer, prostate cancer, and gastric cancer, can play a better therapeutic role, and have formed a mature technology with a wide range of treatments.
Neuroblastoma is the most common malignant (cancerous) extracranial solid tumor in childhood. It develops from the tissue that forms the sympathetic nervous system, which is part of the nervous system that regulates involuntary body functions. Tumors usually start from the nerve tissue of the adrenal glands (above the kidneys), but may also start from the nerve tissue of the neck, chest, or pelvis. Although neuroblastoma usually exists at birth, it is usually not discovered until the tumor begins to grow and compress surrounding organs. Cancer cells can quickly metastasize (spread) to other parts of the body, such as lymph nodes, liver, lungs, bones, central nervous system, and bone marrow. Nearly 70% of children diagnosed with neuroblastoma will have metastatic disease. In children under the age of 15, 10.54 cases of neuroblastoma occur every 1 million children every year. About 37% of patients are diagnosed during infancy (<. 1 year old), and 90% of patients are younger than 5 years old. The average age of onset is 19 months. According to the World Health Organization report, childhood cancer is relatively rare, and childhood cancer patients only account for 0.5% to 4.6% of the total number of cancer patients. Cystic adrenal masses were identified by non-contrast fetal MRI at 36 weeks and 2 days of pregnancy. The white arrow points to the 3.1×3×2.8 cm lesion of the left adrenal gland. First, the signs and symptoms of the disease neuroblastoma depend on which part of the body is affected. 1. Symptoms and signs of abdominal neuroblastoma A, abdominal pain, B, hard abdominal C, changes in bowel habits, such as diarrhea or constipation 2, symptoms and signs of chest neuroblastoma A, wheezing B, chest pain C, eyes Changes include drooping eyelids and uneven pupil size3, other signs and symptoms of neuroblastoma A, subcutaneous tissue mass B, protruding eyeball C, dark circles around the eye similar to bruise D, back pain E, fever F , Unexplained weight loss G, bone pain three: the reason is usually that cancer starts with gene mutations, cancer cells grow and reproduce uncontrollably, and the abnormal cells that gather form clumps (tumors). Neuroblastoma begins with neuroblasts, immature nerve cells produced by the fetus during development. As the fetus matures, neuroblasts will eventually become nerve cells and fibers and the cells that make up the adrenal glands. Most neuroblasts will mature at birth, although a small amount of immature neuroblasts will be found in newborns. In most cases, these neuroblasts mature or disappear. However, others form tumors-neuroblastoma. Most neuroblastoma cells have abnormalities involving specific chromosomes (chromosome 1), and more malignant tumors usually have multiple copies of the oncogene MYCN in tumor cells, but there may also be many other genetic abnormalities. Four: Risk factors Children with a family history of neuroblastoma are more likely to suffer from this disease. Five: Complication 1, cancer spread (metastasis), neuroblastoma may spread (metastasize) to other parts of the body, such as lymph nodes, bone marrow, liver, skin and bones. 2. The spinal cord is compressed, and the tumor may grow and press on the spinal cord, causing the spinal cord to be compressed. Compression of the spinal cord may cause pain and paralysis. 3. Signs and symptoms caused by tumor secretions. Neuroblastoma cells may secrete certain chemicals, which will stimulate other normal tissues and cause signs and symptoms called paraneoplastic syndrome. A paraneoplastic syndrome that rarely occurs in patients with neuroblastoma can cause rapid eye movement and coordination difficulties. Another rare syndrome causes swelling of the abdomen and diarrhea. Six: Diagnosis 1, urine and blood tests, urine tests can be used to check certain chemicals caused by excessive production of catecholamines by neuroblastoma cells. 2. Sample test, imaging examination can show a tumor mass. Imaging tests can include X-rays, ultrasound, computed tomography (CT) scans, inter-iodobenzylguanidine (MIBG) scans, and magnetic resonance imaging (MRI), etc.3. Biopsy, if a mass is found, the doctor may wish to take out a tissue sample to perform Laboratory examination. Special testing of tissue samples can reveal which types of cells are involved in the tumor and the specific genetic characteristics of cancer cells4. Take a bone marrow sample for testing to see if the neuroblastoma has spread to the bone marrow-the spongy shape inside the largest bone that forms blood cells substance. To remove the bone marrow for testing, insert a needle into the body
The adhesion of the olfactory groove meningioma and dura mater is located at the anterior cranial fossa floor and behind it. Durante successfully removed the olfactory groove meningioma in 1885, and the patient survived for 12 years after surgery. Olfactory groove meningioma can be divided into unilateral or bilateral, unilateral is more common, the tumor can also extend from one side to the other. The early symptoms of olfactory groove meningiomas are gradual loss of olfactory sense. When the tumor is unilateral, the loss of olfactory sense is unilateral, which is meaningful for localization diagnosis. However, if it is bilateral loss, it is often confused with rhinitis. Although olfactory disorders are more common, they are often overlooked by many patients. Many patients were confirmed when they were examined in the hospital. This is because unilateral olfactory disorders can be compensated by the contralateral side, and it is not easy for patients to detect. In addition, olfactory groove meningioma It is the loss of olfaction, which is different from the phantom olfactory caused by temporal lobe lesions. It should be noted that because the early olfactory dysfunction is often ignored by patients, how long the tumor is not found. The tumor has grown very large at the time of clinical diagnosis. Symptoms of increased intracranial pressure. Olfactory groove meningiomas are meningeal endothelial cell tumors, which may be derived from arachnoid villi or embryonic remnants. Including 11 types, meningeal endothelial type, fibrous type, mixed type, mitochondrial type, vascular type, microcystic type, secretory type, clear cell type, notochord-like type, lymphoplasma cell type, metaplastic type. The most common of these is the meningeal endothelial type, which accounts for about 53.5% of olfactory groove meningioma. Olfactory groove meningiomas are spherical and flat. Spherical is more common, the surface is intact or nodular, and the colored membrane is often connected to the dura with a “umbilical”; the flat-shaped thickness often does not exceed 1cm, and is widely distributed on the dura mater and is more common at the base of the skull. Olfactory groove meningiomas are rich in blood vessels, and are mostly supplied by the external and internal cervical (or vertebral base) arteries. The cut surface of the tumor is dark red, and may have creamy yellow areas with lipid deposition. Common braided structures are sometimes seen. Sometimes calcified sands are seen, and a few have cystic changes. The morphology of olfactory groove meningiomas has many manifestations, but each type has a basic structure of olfactory groove meningiomas, containing components of meningeal endothelial cells, and the cell arrangement often retains some characteristics of arachnoid villi and arachnoid particles, showing a vortex Shaped or concentric circles, the middle of these concentric circles are prone to transparent degeneration or calcification. Fibrous tissue, vascular tissue, fat, bone or cartilage, and melanin can be seen in the tumor tissue. The malignancy of the tumor is grade Ⅰ. The early symptoms of olfactory groove meningiomas are gradual loss of olfactory sense. When the tumor is unilateral, the loss of olfactory sense is unilateral, which is meaningful for localization diagnosis. However, if it is bilateral loss, it is often confused with rhinitis. Although olfactory disorders are more common, they are often overlooked by many patients. Many patients were confirmed when they were examined in the hospital. This is because unilateral olfactory disorders can be compensated by the contralateral side, and it is not easy for patients to detect. In addition, olfactory groove meningioma It is the loss of olfaction, which is different from the phantom olfactory caused by temporal lobe lesions. It should be noted that because the early olfactory dysfunction is often ignored by patients, how long the tumor is not found. The tumor has grown very large at the time of clinical diagnosis. Symptoms of increased intracranial pressure. Visual impairment is also more common. The cause of vision loss is increased intracranial pressure, optic disc edema and secondary atrophy. Another cause of vision loss is that the tumor develops directly and directly oppresses the optic nerve. Individual patients may have double temporal or single Lateral temporal hemianopia, literature reports that about 1/4 of patients constitute Foster-Kennedy syndrome. Tumors affect frontal lobe function, can cause mental symptoms, patients appear excited, hallucinations, and delusions, but also can be manifested as unresponsiveness and apathy due to increased intracranial pressure. A small number of patients may have seizures, pyramidal tract signs or late tumors Limb tremor is a manifestation of tumor compression of the internal capsule or basal ganglia.
People often talk about “cancer” discoloration because the tumor has the characteristics of infinite proliferation, invasion, recurrence and metastasis. Most cancer patients will undergo a comeback after standardized treatments such as surgery, chemotherapy, and radiotherapy, which is what we often say is relapse. Once a recurrence occurs, it means that the disease has entered the middle and late stages, and it is difficult to achieve clinical cure, which brings great problems to tumor patients. 1. You need to understand what is the recurrence of the tumor. Recurrence refers to the treatment of the tumor after surgical resection or radiotherapy and chemotherapy. After the tumor subsides, it reappears at the original site, or the cancer cells invade the lymphatic vessels and migrate to other places to grow and form the original Tumors with the same pathological type. Malignant tumors often easily invade the surrounding tissues and are not easy to completely clear and recur, but some benign tumors can also recur. For example, multi-line adenoma of salivary gland tissue can easily recur and malignant transformation can occur. Tumor recurrence is divided into local recurrence, regional recurrence and distant recurrence.  . Local recurrence means that the tumor grows again at or near the same site as the primary cancer. For example, after the tumor of the left upper lobe lung cancer subsides after chemotherapy, new nodules or massive tumors grow on the original site. In general, local recurrence does not spread to lymph nodes or other parts of the body. Regional recurrence refers to cancer cells breaking through the primary cancer area and appearing in nearby lymph nodes or tissues. Such as recurrence of lung cancer and invasion of hilar lymph nodes. Distant recurrence means that the tumor grows in other tissues and organs far from the original growth site, usually in the lung, liver, bone, brain, etc. This type of recurrence is also called metastasis.  . Second, the recurrence and progression of the tumor are very different. Recurrence emphasizes that the tumor had a process of regression, and then reappeared after a period of time. Progress means that the tumor continues to develop on the original basis. But sometimes it is difficult to tell the difference between relapse and progression. For example, if the cancer recurs after three months of regression, has the cancer really subsided? Is this a relapse or progress? At this time, the following two situations are likely to occur: 1. The surgery has not completely cleared the cancer cells. After the operation, some tiny cancer cell groups remain, which cannot be found by naked eyes and image scanning. Over time, their growth increased to the extent that image scans could detect or caused some symptoms before they were discovered. This type of cancer is often extremely aggressive. This situation is often referred to as a relapse, after all, the tumor has been surgically removed. 2. Cancer cells have become resistant to drugs. Drug resistance is divided into two major categories: primary drug resistance (existing when not exposed to drugs) and acquired drug resistance (generated after exposure to drugs). Once cancer cells become resistant, conventional drugs will not kill them, and they will survive and become the source of relapse. No matter what kind of drug resistance, as long as the tumor completely disappears after the treatment process, it can be called a relapse; otherwise, if the tumor has not completely resolved, it is progress. 3. How do patients judge whether they have relapsed? Patients must have a lot of doubts. Does the body appear abnormal during the recovery period to indicate that the tumor has relapsed? How can I determine if it is a relapse? To determine whether the tumor has recurred, we should start with the patient’s clinical manifestations and auxiliary examination. 1. Clinical Symptoms When the patient reappears the symptoms of the newly diagnosed cancer, he must be alert to relapse. Of course, it also includes some other symptoms, such as unexplained fever, unexplained weight loss, progressive fatigue, bleeding, and pain. 2. The patient’s sign cancer cells often metastasize through the lymphatic vasculature. When patients find enlarged lymph nodes and local painless masses, they should see a doctor in time, most commonly in the lower cervical triangle (neck, mandible, clavicle fossa), axilla , Groin and other parts. 3. Examination of tumor markers Mention of cancer markers. The first thing that comes to mind is tumor markers. The tumor marker is a soluble glycoprotein that is present in the blood, urine, or tissues of some cancer patients. It is usually produced by tumor cells, but in some cases it can also be produced by normal cells. Elevated tumor markers do not mean that you have cancer. Only a sustained and substantial increase has clinical significance. Currently commonly used tumor markers are carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP), prostate-specific antigen (PSA), squamous cell carcinoma-associated antigen (SCC), carbohydrate antigen 125 (CA125), carbohydrate antigen (CA199), carbohydrate antigen 153 (CA153), carbohydrate antigen 724 (CA724)