儿童颞叶多形性黄色瘤型星形细胞瘤的临床分析  

Clinical features of pediatric pleomorphic xanthoastrocytoma in temporal lobe

作　　者：武文浩[1] 左鹏程 宫剑[1] 李春德[1] Wu Wenhao;Zuo Pengcheng;Gong Jian;Li Chunde(Department of Neurosurgery,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院神经外科,100070

出　　处：《中华神经外科杂志》2019年第5期438-442,共5页Chinese Journal of Neurosurgery

基　　金：国家"十二五"科技支撑计划(2014BAI04B01,2015BAI12B04).

摘　　要：目的探讨儿童颞叶多形性黄色瘤型星形细胞瘤的临床特征、诊断及治疗策略。方法回顾性分析2009年7月至2018年2月首都医科大学附属北京天坛医院神经外科收治的并经病理证实的7例儿童颞叶多形性黄色瘤型星形细胞瘤患者的临床资料。7例患者均行开颅手术治疗,其中经额颞入路6例,经颞枕入路1例。分析患者的临床特征、影像学特点、治疗情况及随访结果。结果7例儿童颞叶多形性黄色瘤型星形细胞瘤患者中,6例首发症状为癫痫发作;影像学上肿瘤呈实性或以实性为主5例,囊实性2例。肿瘤全切除6例,近全切除1例;术后行放疗1例,行放疗和化疗1例。术后随访18~100个月,中位随访时间为32个月,失访1例,6例患者的癫痫症状控制良好,均未发现肿瘤复发。结论儿童颞叶多形性黄色瘤型星形细胞瘤患者的临床表现以癫痫发作为主,影像学上肿瘤多伴囊性改变,实性部分明显强化;临床首选外科手术治疗,全切除与良好预后相关。Objective To explore the clinical features, diagnosis and therapeutic strategies of pediatric pleomorphic xanthoastrocytoma arising in temporal lobe. Methods A total of 7 pediatric patients diagnosed as pleomorphic xanthoastrocytoma were treated in Neurosurgery Department of Beijing Tiantan Hospital, Capital Medical University between July 2009 and February 2018 and histologically confirmed. All those patients underwent surgical operation. The frontotemporal approach was taken in 6 patients and temporal-occipital approach was used in 1. Their clinical data, imaging features, treatment and outcomes were analyzed retrospectively. Results The initial symptom was epileptic seizure in 6 patients. Radiologically, the tumors were completely or mainly solid in 5 patients, and were solid-cystic in 2 patients. The tumors were totally removed in 6 patients, except one with subtotal resection. After operation, radiotherapy was undergone in 1 patient and chemo-radiotherapy in 1. The median follow-up time was 32 months, ranging from 18 to 100 months. One patient was lost to follow-up. The seizures were well controlled and the tumor had no signs of recurrence in this series. Conclusions Epileptic seizure seems to be the most common symptom for pediatric pleomorphic xanthoastrocytoma in temporal lobe. Radiologically, the tumors are usually associated with cystic changes. The primary treatment is surgical operation, and total removal is usually correlated with good prognosis.

关 键 词：星形细胞瘤 颞叶 疾病特征 神经外科手术 儿童 

分 类 号：R739.41[医药卫生—肿瘤]