Akiyama Hideyuki, Nakamizo Satoshi, Kawamura Atsushi, Nagashima Tatsuya, Hasegawa Daiichirou, Kosaka Yoshiyuki, Yoshida Makiko
Department of Neurosurgery, Hyogo Prefectural Kobe Children's Hospital, 1-1-1, Takakuradai, Suma-ku, Kobe City, Hyogo 654-0081, Japan.
No Shinkei Geka. 2006 Dec;34(12):1255-60.
The authors present a pediatric case of ganglioglioma occurring in the medulla oblongata. A 7-year-old boy was referred to our hospital with complaints of ataxia, seizure and sleep apnea. MRI of the brain disclosed a large tumor occupying the medulla oblongata, and the upper portion of the cervical spinal cord was also involved. The patient underwent midline suboccipital craniotomy and laminectomy of C1 to attempt radical resection of the tumor, which resulted only in partial removal of the tumor due to severe bradycardia during the operation. The histological diagnosis was ganglioglioma, WHO grade 2. Although both radiotherapy and chemotherapy were performed following the operation, the tumor remained unchanged. The patient died of respiratory arrest five months after the operation. Gangliogliomas usually occur in the supratentorial region, which permits easy surgical access and good prognosis. Only 3% of gangliogliomas occur in the brain stem, and its management can be challenging because of the difficulty of radical resection and poor response to both radiotherapy and chemotherapy.
作者报告了一例发生于延髓的小儿神经节胶质瘤病例。一名7岁男孩因共济失调、癫痫发作和睡眠呼吸暂停被转诊至我院。脑部MRI显示一个巨大肿瘤占据延髓,颈髓上部也受累。患者接受了枕下正中开颅术和C1椎板切除术,试图根治性切除肿瘤,但由于手术期间严重心动过缓,仅部分切除了肿瘤。组织学诊断为神经节胶质瘤,WHO 2级。尽管术后进行了放疗和化疗,但肿瘤仍无变化。患者术后五个月死于呼吸骤停。神经节胶质瘤通常发生在幕上区域,手术易于进行且预后良好。仅3%的神经节胶质瘤发生在脑干,由于根治性切除困难以及对放疗和化疗反应不佳,其治疗具有挑战性。