Background: Tumor-like lesions at the craniovertebral junction mimic tumors in clinical presentation and imaging. Our study focuses on three common developmental pathologies—epidermoids, dermoids and neurenteric cysts.Methods: We conducted a retrospective analysis of a case series and a meta-analysis of 170 patients from 119 reports.Results: Neurenteric cysts predominated (81.2%). Anterior cysts were linked to neurenteric cysts, while posterior ones correlated with dermoid/epidermoid cysts (p< 0.001). Complications occurred in 27.2% of cases, with cranial nerve paresis being the most common. Most patients had excellent outcomes (75.2%) with low recurrence rates (12%). Dermoid cysts were more associated with anomalies (p< 0.001). Among 138 neurenteric cyst cases, 15 experienced recurrence, with predictors including ages 51–60 and over 70, subtotal resection, complications, and poor outcomes (p< 0.001). Cysts with total resection were significantly less likely to adhere to surrounding brain tissue (p< 0.001). CSF diversion was correlated with older age (p= 0.010) and various complications (p< 0.001). Age affected outcomes, and the hydrocephalus was linked to poor outcomes (p= 0.002).Conclusions:This meta-analysis underscores the importance of total resection in minimizing recurrence rates and emphasizes meticulous preoperative planning and imaging. Our results indicate that rim enhancement (p= 0.047) and poor outcome (p= 0.007) are significant factors associated with recurrence. Additionally, associated anomalies, as well as the patient’s age and overall health, significantly influence the surgical outcomes and the likelihood of recurrence.
背景：颅颈交界区肿瘤样病变在临床表现和影像学上易与肿瘤混淆。本研究聚焦于三种常见的发育性病变——表皮样囊肿、皮样囊肿和神经管肠源性囊肿。 方法：我们对病例系列进行了回顾性分析，并对来自119篇报告的170例患者进行了荟萃分析。 结果：神经管肠源性囊肿占主导地位（81.2%）。前部囊肿与神经管肠源性囊肿相关，而后部囊肿则与皮样/表皮样囊肿相关（p<0.001）。并发症发生率为27.2%，其中颅神经麻痹最为常见。大多数患者预后良好（75.2%），复发率较低（12%）。皮样囊肿更常伴随异常（p<0.001）。在138例神经管肠源性囊肿病例中，15例出现复发，预测因素包括年龄51-60岁及70岁以上、次全切除、并发症和不良预后（p<0.001）。完全切除的囊肿显著较少与周围脑组织粘连（p<0.001）。脑脊液分流与年龄较大（p=0.010）及多种并发症相关（p<0.001）。年龄影响预后，脑积水与不良预后相关（p=0.002）。 结论：本荟萃分析强调了完全切除对降低复发率的重要性，并强调了细致的术前规划和影像学评估。我们的结果表明，边缘强化（p=0.047）和不良预后（p=0.007）是与复发相关的重要因素。此外，相关异常、患者年龄及整体健康状况显著影响手术结果和复发可能性。
肿瘤(癌症)患者之家