Aryan Henry E, Imbesi Steven G, Amjadi Darius K, Abshire Bret B
Division of Neurosurgery, University of California, San Diego Medical Center, San Diego, California 92103-8893, USA.
Neurosurgery. 2003 Oct;53(4):985-7; discussion 987-8. doi: 10.1227/01.neu.0000084080.83180.2a.
Reported is a case of a thoracic intramedullary astrocytoma with a lipomatous component, a so-called astrolipoma. This is the only known case of a single intraspinal astrolipoma in an otherwise healthy patient.
The patient was a 36-year-old woman with dorsal thoracic pain of more than 1 month's duration, mild lower extremity weakness, and incomplete sensory loss to the T10 level.
Magnetic resonance imaging of the thoracolumbar spine revealed a fusiform mass at the T9-T11 level. The patient underwent T9-T11 laminectomies and complete resection of the tumor. In the initial postoperative period, the patient's symptoms worsened. However, 3 months after surgery, the patient was clinically improved and was able to walk without assistance. Twelve months after surgery, imaging revealed no evidence of tumor.
The current treatment plan and recommendation, assuming this tumor will behave like a low-grade glioma or lipoma, is continued radiographic surveillance after gross total resection. Reresection is recommended for tumor recurrence or significant regrowth. The long-term prognosis for astrolipoma is unknown.
报告一例伴有脂肪瘤成分的胸段髓内星形细胞瘤，即所谓的星形脂肪瘤。这是已知唯一一例在其他方面健康的患者中发生的单一脊髓内星形脂肪瘤病例。
患者为一名36岁女性，背痛持续超过1个月，下肢轻度无力，T10水平以下感觉丧失不完全。
胸腰椎磁共振成像显示T9 - T11水平有一梭形肿块。患者接受了T9 - T11椎板切除术及肿瘤全切术。术后初期，患者症状加重。然而，术后3个月，患者临床症状改善，能够独立行走。术后12个月，影像学检查未发现肿瘤迹象。
假设该肿瘤表现类似低级别胶质瘤或脂肪瘤，目前的治疗方案及建议是在肿瘤全切术后继续进行影像学监测。对于肿瘤复发或显著再生长，建议再次手术切除。星形脂肪瘤的长期预后尚不清楚。
