Watanabe Yosuke, Oki Shuichi, Migita Keisuke, Isobe Naoyuki, Okazaki Takahito, Nabika Shinya
Department of Neurosurgery, Hiroshima City Asa Hospital, 2-1-1 Kabe-minami, Kita-ku, Asa, Hiroshima-city, Hiroshima 731-0293, Japan.
No Shinkei Geka. 2003 May;31(5):543-8.
The authors present a case of a subependymal giant cell astrocytoma (SGCA) not associated with tuberous sclerosis. On admission, a six-year-old boy had obstructive hydrocephalus caused by a huge intraventricular tumor. Preoperative T1-weighted MR images with gadolinium showed heterogeneous enhancement of the lesion. The tumor was totally removed through a right transcortical approach with frontal craniotomy. Immunohistochemical staining for glial fibrillary acidic protein (GFAP) showed a positive reaction in some of the large tumor cells and the labeling index of MIB-1 was < 1.0%. Histological examinations revealed SGCA. He has no other evidence of tuberous sclerosis at present, but the patient in this case is an infant, so there is a possibility of his being diagnosed as tuberous sclerosis in the future. Therefore, systemic regular follow-up is recommended, even when his condition is asymptomatic.
作者报告了一例与结节性硬化症无关的室管膜下巨细胞星形细胞瘤(SGCA)。入院时,一名六岁男孩因巨大的脑室内肿瘤导致梗阻性脑积水。术前钆增强T1加权磁共振成像显示病变呈不均匀强化。通过右侧经皮质额叶开颅手术将肿瘤完全切除。胶质纤维酸性蛋白(GFAP)免疫组化染色显示部分大肿瘤细胞呈阳性反应,MIB-1标记指数<1.0%。组织学检查显示为SGCA。目前他没有其他结节性硬化症的证据,但该病例患者为婴儿,因此未来有可能被诊断为结节性硬化症。因此,即使他无症状,也建议进行系统的定期随访。