Mantadakis Elpis, Raissaki Maria, Danilatou Vassiliki, Kambourakis Alexander, Stiakaki Eftichia, Kalmanti Maria
Department of Pediatric Hematology/Oncology, University Hospital of Heraklion, Heraklion, Crete, Greece.
J Neurooncol. 2004 Mar-Apr;67(1-2):95-100. doi: 10.1023/b:neon.0000021740.50003.27.
We describe the case of an 8-year-old girl without neurofibromatosis, who presented with total loss of vision on the left eye, due to a chiasmatic mass with imaging characteristics of glioma, accompanied by a second asymptomatic mass in the middle cranial fossa, along the intracranial route of the right trigeminal nerve. The patient received a total of 10 weekly injections of vincristine and four injections of carboplatin every 3 weeks and achieved a very good partial response (97% volume reduction) after the nineth week of therapy with acceptable toxicity. Given the natural history of opticochiasmatic gliomas, we cannot rule out the possibility of a spontaneous regression. However, we believe the quick response accompanied by visual improvement was most likely due to chemotherapy. A trial of vincristine and carboplatin may be worthwhile in children with symptomatic chiasmatic gliomas, irrespective of their age.
我们描述了一名8岁无神经纤维瘤病的女孩的病例,她因视交叉肿物出现左眼视力完全丧失,该肿物具有胶质瘤的影像学特征,同时在中颅窝沿右侧三叉神经颅内走行处伴有第二个无症状肿物。患者共接受了10次每周一次的长春新碱注射以及每3周4次的卡铂注射,在治疗第9周后获得了非常好的部分缓解(体积缩小97%),且毒性可接受。鉴于视交叉胶质瘤的自然病程,我们不能排除自发消退的可能性。然而,我们认为快速缓解并伴有视力改善最可能是由于化疗。对于有症状的视交叉胶质瘤患儿,无论其年龄大小,长春新碱和卡铂试验可能是值得的。