Gottfried Oren N, Fults Daniel W, Townsend Jeannette J, Couldwell William T
Department of Neurosurgery, University of Utah, Salt Lake City, Utah 84132, USA.
J Neurosurg. 2003 Aug;99(2):416-20. doi: 10.3171/jns.2003.99.2.0416.
Pilomyxoid astrocytomas have been identified as a more aggressive variant of pilocytic astrocytomas that occur in infants and in young children. These tumors are characterized by a perivascular arrangement of pilocytic cells that has a monomorphous architecture with uniform, elongated bipolar cells loosely ranged within a prominent myxoid background. The authors present the case of a 24-year-old man with a pilomyxoid astrocytoma of the temporal lobe, who presented with a hemorrhage. The patient underwent gross-total tumor resection, and no evidence of residual or recurrent tumor was found on magnetic resonance images at the 6-month follow-up examination. The occurrence of a pilomyxoid astrocytoma in an adult suggests that this tumor is not limited to children. The tumor described in this report is unique because of its presentation with a hemorrhage, which has not been previously described in cases of pilomyxoid astrocytomas and is rarely found in those of pilocytic astrocytomas. Although this tumor predominantly exhibited the pattern of a pilomyxoid astrocytoma, there was a small focus of pilocytic astrocytoma, indicating that there is a spectrum of histological components found in these tumors and that certain elements may be associated with a more aggressive phenotype. In this paper the authors review the literature on pilomyxoid astrocytomas and discuss the unique aspects of this particular tumor presentation.
毛黏液样星形细胞瘤已被确认为一种侵袭性更强的毛细胞型星形细胞瘤变体，多见于婴幼儿。这些肿瘤的特征是毛细胞呈血管周围排列，具有单一形态结构，由均匀、细长的双极细胞松散排列在显著的黏液样背景中。作者报告了一例24岁颞叶毛黏液样星形细胞瘤男性患者，该患者表现为出血。患者接受了肿瘤全切术，在6个月的随访磁共振成像检查中未发现残留或复发肿瘤的迹象。成人发生毛黏液样星形细胞瘤表明该肿瘤并不局限于儿童。本报告中描述的肿瘤因其出血表现而独特，此前毛黏液样星形细胞瘤病例中未见此类描述，在毛细胞型星形细胞瘤中也很少见。尽管该肿瘤主要表现为毛黏液样星形细胞瘤的模式，但有一小灶毛细胞型星形细胞瘤，表明这些肿瘤存在一系列组织学成分，且某些成分可能与更具侵袭性的表型相关。本文作者回顾了毛黏液样星形细胞瘤的文献，并讨论了这种特殊肿瘤表现的独特之处。
