Ng H K, Leung C H, Boet R, Poon W S
Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Hong Kong, P.R. China.
J Clin Neurosci. 2001 Jul;8(4):374-7. doi: 10.1054/jocn.2000.0762.
Dissemination of tumour cells along the cerebrospinal fluid (CSF) pathway has been reported mostly in medulloblastomas, germ cell tumours or high grade gliomas. Juvenile pilocytic astrocytoma (JPA) is usually a benign astrocytoma. However, drop metastases of indolent nature from intracranial tumours to the spinal cord are documented. All of the previously reported cases represent metastases of cerebellar or hypothalamic tumours spreading to the spinal cord. We document in this paper the first report of a spinal cord pilocytic astrocytoma spreading via the CSF to the cerebral meninges. A 9 year old girl had a JPA of C5 to C7 subtotally resected. Two and a half years later she presented with hydrocephalus with radiologically meningeal enhancement. The meninges were biopsied which showed metastatic JPA. The girl was relatively well 4 years after initial surgery with residual tumour. Spinal cord JPA can rarely metastasize to the cranial meninges. Similar to intracranial tumours which spread to the spinal cord, such metastatic lesions are indolent.
肿瘤细胞沿脑脊液（CSF）途径播散的情况大多见于髓母细胞瘤、生殖细胞瘤或高级别胶质瘤。青少年毛细胞型星形细胞瘤（JPA）通常是一种良性星形细胞瘤。然而，已有颅内肿瘤向脊髓发生惰性播散性转移的记录。所有先前报道的病例均为小脑或下丘脑肿瘤转移至脊髓。我们在本文中首次报告了一例脊髓毛细胞型星形细胞瘤经脑脊液播散至脑膜的病例。一名9岁女孩接受了C5至C7节段JPA的次全切除。两年半后，她出现脑积水，影像学显示脑膜强化。对脑膜进行活检，结果显示为转移性JPA。初次手术后4年，该女孩情况相对良好，仍有残留肿瘤。脊髓JPA很少转移至颅脑膜。与转移至脊髓的颅内肿瘤相似，此类转移性病变具有惰性。
