de León-Bojorge Beatriz, Rueda-Franco Fernando, Anaya-Jara Marcial
Department of Pathology, National Institute of Pediatrics, Mexico, Mexico.
Childs Nerv Syst. 2008 Mar;24(3):307-12. doi: 10.1007/s00381-007-0464-9. Epub 2007 Sep 18.
The purpose of this study is to present our experience with ten cases of Central nervous system atypical teratoid rhabdoid tumor (CNS/ATRT).
A series of ten patients with CNS/ATRT, were diagnosed and treated between 1990 and 2005, at the National Institute of Pediatrics, in Mexico City. The gender, age of presentation, clinical features, tumor localization, imaging studies, grade of tumor resection, complications, adjuvant therapy, and survival are presented.
The mean age at diagnosis was 37.8 months, seven cases were male, and their average clinical course was 1.3 months. The more common clinical presentation was intracranial hypertension with cranial nerve deficits; location was infratentorial in four patients and supratentorial in six. Hydrocephalus was present as the most common complication (seven cases). In nine patients, the grade of resection was total or subtotal. In one case, it was only possible to perform a biopsy. There were two cases with longer survival (9 and 16 months), and their tumors were resected in total or subtotal manner and received adjuvant therapy (radiotherapy and chemotherapy).
Preliminary results, show that in older children, we can improve their survival with the subtotal or total resection of the tumor and the addition of chemotherapy and radiotherapy.
本研究旨在介绍我们对10例中枢神经系统非典型畸胎样横纹肌样瘤(CNS/ATRT)的治疗经验。
1990年至2005年间,在墨西哥城国家儿科研究所诊断并治疗了一系列10例CNS/ATRT患者。介绍了患者的性别、发病年龄、临床特征、肿瘤定位、影像学检查、肿瘤切除分级、并发症、辅助治疗及生存情况。
诊断时的平均年龄为37.8个月,7例为男性,平均病程为1.3个月。最常见的临床表现是颅内高压伴脑神经功能缺损;4例肿瘤位于幕下,6例位于幕上。脑积水是最常见的并发症(7例)。9例患者的肿瘤切除分级为全切或次全切。1例仅行活检。2例生存期较长(9个月和16个月),其肿瘤行全切或次全切并接受辅助治疗(放疗和化疗)。
初步结果表明,对于年龄较大的儿童,肿瘤次全切或全切并加用化疗和放疗可提高其生存率。