Honda Masaru, Baba Hiroshi, Yonekura Masahiro, Iseki Masachika
Department of Neurosurgery, National Nagasaki Medical Center, Omura, Japan.
Neurol Med Chir (Tokyo). 2005 Jun;45(6):318-21. doi: 10.2176/nmc.45.318.
A 1-year-old male infant presented with a rare cerebral composite tumor consisting of atypical teratoid/rhabdoid tumor (AT/RT) with epithelial and mesenchymal components and yolk sac tumor (YST) with Schiller-Duval bodies. He was admitted to our medical center with a 2-month history of right hemiparesis. Computed tomography and magnetic resonance imaging revealed a large, intra-axial solid tumor with a cyst in the left frontal lobe. Total resection of the tumor was performed. Histological examination showed two different main growth patterns: solid sheets of undifferentiated polygonal cells and a few rhabdoid cells with rosette structures and rhabdomyoblastic cells; and reticular or papillary structures with occasional Schiller-Duval bodies in a myxoid matrix. The immunohistochemical and electron microscopy findings indicated composite AT/RT and YST. Initial total resection of the tumor was subsequently followed by local recurrence, hydrocephalus, and spinal metastasis. Despite adjuvant chemotherapy, the patient died 9 months after admission. AT/RT is a recently established entity of the central nervous system. The present case of composite AT/RT and YST in the frontal lobe indicates the poor prognosis of such tumors.
一名1岁男婴出现一种罕见的脑复合肿瘤,由具有上皮和间充质成分的非典型畸胎样/横纹肌样瘤(AT/RT)以及具有席勒-杜瓦尔小体的卵黄囊瘤(YST)组成。他因右半身轻瘫2个月病史入住我们的医疗中心。计算机断层扫描和磁共振成像显示左额叶有一个大的轴内实性肿瘤并伴有一个囊肿。对肿瘤进行了全切除。组织学检查显示两种不同的主要生长模式:未分化多边形细胞的实性片层以及少数具有玫瑰花结结构的横纹肌样细胞和成横纹肌细胞;以及在黏液样基质中具有偶尔席勒-杜瓦尔小体的网状或乳头状结构。免疫组织化学和电子显微镜检查结果表明为复合性AT/RT和YST。肿瘤最初全切除后随后出现局部复发、脑积水和脊柱转移。尽管进行了辅助化疗,患者在入院9个月后死亡。AT/RT是中枢神经系统最近确定的一种实体。本例额叶复合性AT/RT和YST表明此类肿瘤预后不良。