室管膜下巨细胞型星形细胞瘤六例分析  

Subependymal giant cell astrocytoma： report of 6 cases

作　　者：尚爱加[1] 余新光[1] 许百男[1] 周定标[1] 姜金利[1] 

机构地区：[1]解放军总医院神经外科,北京100853

出　　处：《中华神经医学杂志》2008年第10期1027-1029,共3页Chinese Journal of Neuromedicine

摘　　要：目的探讨室管膜下巨细胞型星形细胞瘤（SEGA）患者的临床、影像学、病理学特点以及诊断和治疗方法。方法对自2000年2月至2007年8月收治的6例SEGA患者的临床和影像学表现、病理学特点、治疗及随访结果进行回顾分析。结果6例SEGA的临床表现以高颅压和视力下降最为常见：CT显示肿瘤实体部分呈等或稍高密度，边界清楚，部分可见瘤内钙化。MRI扫描肿瘤实体部分T1WI多呈等信号，少数可呈稍低信号；T2WI呈等或稍高信号：增强扫描肿瘤实体部分呈不均匀强化。4例经胼胝体入路，2例经额叶皮质入路，肿瘤全切除均成功，无手术死亡，随访10月～8年，肿瘤无复发。结论室管膜下病变如位于室间孔周围伴有结节性硬化，引起恼积水或呈现逐渐生长趋势者，应考虑SEGA的诊断，尽早手术治疗。SEGA为良性肿瘤，手术全切者预后良好。定期影像学检查对于跟踪室管膜下结节以及监测肿瘤复发是必要的。Objective To study the clinical manifestations, radiological features, and postoperative outcomes of patients with subependymal giant cell astrocytoma （SEGA）. Methods A retrospective analysis of the clinical presentations, imaging examinations, pathological features, treatments and follow-up results was conducted in 6 SEGA cases treated in our department from 2000 to 2007. Results The most common clinical maifestations of SEGA included increased intracranial pressure and impaired visual acuity. CT scan of the tumors displayed isodensity or slightly increased density with well defined border. Calcification was seen in some of the tumors. On T1-weighted magnetic resonance images, the tumor masses presented with isointense or mixed signals, while on T2-weighted images, the tumors exhibited isointense or hyperintense signals. The solid part of the tumor showed heterogeneous enhancement in contrast-enhanced imaging. No operative death occurred in these cases after total removal of the tumors through a transcallosal approach （4 cases） or a frontal transcortical approach （2 cases）. No postoperative tumor recurrence was found in the follow-up for 10 months to 8 years. Conclusion The diagnosis of SGCA should be considered for the presence of tuberous sclerosis in the subependymal lesion adjacent to the foramen of Monro in cases presenting hydrocephalus or progressive tumor growth. Surgical resection of the tumor should be performed as early as possible. SGCA is a benign tumor with good prognosis after a total resection. Regular follow-up examination should be undertaken to monitor the subependymal nodules for prevention of tumor recurrence.

关 键 词：室管膜下巨细胞型星形细胞瘤 结节性硬化 诊断 

分 类 号：R739.4[医药卫生—肿瘤]