Haddad S F, Moore S A, Menezes A H, VanGilder J C
Division of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City.
Neurosurgery. 1992 Aug;31(2):171-8. doi: 10.1227/00006123-199208000-00001.
A 13-year retrospective review of 17 patients with gangliogliomas treated at the University of Iowa was conducted to investigate the association between tumor location, extent of resection, pathological findings, and patient prognosis. Thirteen were in the cerebral hemispheres and 4 in the midline. The mean ages at diagnosis and symptom onset were 16 and 8.8 years, respectively. The most common presenting symptom was seizures (11 patients); focal neurological deficit was seen in 5 patients and headache in 1. Patients with hemispheric tumors had an older age at time of diagnosis and a longer duration of symptoms. Pathologically, they had more microcalcifications, lymphocytic infiltration, microcystic degeneration, and eosinophilic bodies. Cerebral hemispheric tumors were more amenable to total resection than midline neoplasms, 77% versus 25%, respectively. In the patients with hemispheric tumors, 10 patients were tumor-free after total resection. Two of the 3 patients with partial resection had stable residual tumors. The third died of tumor progression. In the 4 patients with midline neoplasms, one was tumor-free after total resection. The other 3 had subtotal resection and radiation therapy. Two died within 2 years; the third is still alive with progressive tumor. Five of 9 patients who had seizure disorders and who underwent total tumor removal were seizure-free postoperatively. The other 4 patients and the 2 with partial surgical resection continued to have seizures.
对爱荷华大学治疗的17例神经节胶质瘤患者进行了一项为期13年的回顾性研究,以调查肿瘤位置、切除范围、病理结果与患者预后之间的关联。13例位于大脑半球,4例位于中线。诊断时和症状出现时的平均年龄分别为16岁和8.8岁。最常见的首发症状是癫痫发作(11例患者);5例患者出现局灶性神经功能缺损,1例出现头痛。半球肿瘤患者诊断时年龄较大,症状持续时间较长。病理上,它们有更多的微钙化、淋巴细胞浸润、微囊性变和嗜酸性小体。大脑半球肿瘤比中线肿瘤更适合全切除,分别为77%和25%。在半球肿瘤患者中,10例患者全切除后无肿瘤。3例部分切除患者中有2例残留肿瘤稳定。第3例死于肿瘤进展。在4例中线肿瘤患者中,1例全切除后无肿瘤。其他3例接受了次全切除和放射治疗。2例在2年内死亡;第3例仍存活,但肿瘤进展。9例患有癫痫疾病且接受肿瘤全切的患者中有5例术后无癫痫发作。其他4例患者和2例接受部分手术切除的患者仍有癫痫发作。