Sano K
Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan.
Neurosurg Rev. 2001 Dec;24(4):162-7; discussion 168-70. doi: 10.1007/s101430100148.
Dysembryogenetic tumors can be classified into three main categories: (1) tumors derived from embryonal cell rests in situ such as craniopharyngioma, Rathke's cleft cyst, chordoma, etc., (2) tumors derived from embryonal cells straying into the tissue ("verirrte Keime") such as so-called germ cell tumors, epidermoid, dermoid, lipoma, hamartoma, etc., and (3) included twin (fetus-in-fetu) tumors. The pathogenesis of the second one may be that the embryonic cells of various stages of embryogenesis are misplaced in the bilaminar embryonic disc at the time of the primitive streak formation, becoming involved in the stream of lateral mesoderm and carried to the neural plate area to become incorrectly enfolded into the brain at the time of neural tube formation. The third category of tumor may be related to sequestration of cells of the blastocyst before differential blocking of the genome has occurred. The author propounds the following hypothesis: intracranial dysembryogenetic tumors composed of cells resembling the cells that appear in the earlier stages of embryogenesis are more malignant than those composed of cells resembling those appearing in the later stages of embryogenesis.
(1)源于原位胚胎细胞残余的肿瘤,如颅咽管瘤、拉克囊囊肿、脊索瘤等;(2)源于误入组织的胚胎细胞(“游走胚细胞”)的肿瘤,如所谓的生殖细胞肿瘤、表皮样囊肿、皮样囊肿、脂肪瘤、错构瘤等;(3)包括孪生(胎内胎)肿瘤。第二类肿瘤的发病机制可能是,在原条形成时,胚胎发育各阶段的胚胎细胞在双胚层胚胎盘中位置异常,卷入侧中胚层流,并在神经管形成时被错误地包裹进脑内。第三类肿瘤可能与囊胚细胞在基因组差异阻断发生之前的隔离有关。作者提出以下假说:由类似于胚胎发育早期出现的细胞组成的颅内胚胎发育异常性肿瘤比由类似于胚胎发育后期出现的细胞组成的肿瘤恶性程度更高。