Umezu H, Seki Y, Aiba T, Matsuya S
Department of Neurosurgery, Toranomon Hospital, Tokyo.
Neurol Med Chir (Tokyo). 1992 May;32(5):281-4. doi: 10.2176/nmc.32.281.
We report a case of intracranial dissemination developing approximately 6 months after partial removal of a spinal cord astrocytoma in a 40-year-old male. The clinical course and postmortem findings indicate that the tumor originated in the cervical cord and extended into the subarachnoid space, first the spinal canal and later intracranially. Spinal cord glioma dissemination through the cerebrospinal fluid is more common than previously considered and indicates a dismal prognosis. An aggressive approach, including radical surgery, entire neuraxis irradiation, and adjuvant chemotherapy, is suggested as the initial treatment for malignant spinal cord glioma to prevent subsequent dissemination.
我们报告了一例40岁男性患者,在脊髓星形细胞瘤部分切除术后约6个月发生颅内播散的病例。临床病程和尸检结果表明,肿瘤起源于颈髓并延伸至蛛网膜下腔,首先是椎管内,随后播散至颅内。脊髓胶质瘤通过脑脊液播散比之前认为的更为常见,且预后不佳。对于恶性脊髓胶质瘤,建议采取积极的治疗方法,包括根治性手术、全神经轴照射和辅助化疗,作为初始治疗以预防后续播散。