Muragaki Yoshihiro, Chernov Mikhail, Tajika Yasuhiko, Kubo Osami, Iseki Hiroshi, Hori Tomokatsu, Takakura Kintomo
Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Shinjuku-ku, Japan.
J Neurooncol. 2009 Jul;93(3):431-5. doi: 10.1007/s11060-008-9793-0. Epub 2009 Jan 29.
Coincidence of parenchymal primary brain tumors of different histogenesis is extremely rare. To the best of our knowledge, the present case of simultaneous appearance of a central neurocytoma and multiple glioblastomas is the first to be reported. Multiple intraaxial brain neoplasms were disclosed in a 39-year-old man and were surgically resected. Histological diagnosis of the tumor located in the right lateral ventricle was central neurocytoma whereas two tumors of the left temporal lobe were glioblastomas. The latter were located in close proximity to the subarachnoid space, had atypical radiological appearance, and were slightly positive for synaptophysin and neurofilament protein. It can be speculated that both malignant neoplasms were, in fact, dedifferentiated central neurocytoma, which developed from distant tumor deposits. This case seems to be in agreement with the hypothesis that central neurocytoma arises from the progenitor cells with potential for both neuronal and glial differentiation. Better understanding of histogenesis of this tumor is definitely needed.
不同组织发生的脑实质原发性肿瘤同时出现极为罕见。据我们所知,目前同时出现中枢神经细胞瘤和多个胶质母细胞瘤的病例是首例报道。在一名39岁男性中发现了多个脑内肿瘤并进行了手术切除。位于右侧脑室的肿瘤组织学诊断为中枢神经细胞瘤,而左侧颞叶的两个肿瘤为胶质母细胞瘤。后者紧邻蛛网膜下腔,具有非典型的影像学表现,突触素和神经丝蛋白呈弱阳性。可以推测,这两种恶性肿瘤实际上都是去分化的中枢神经细胞瘤,由远处的肿瘤沉积物发展而来。该病例似乎支持中枢神经细胞瘤起源于具有神经元和胶质细胞分化潜能的祖细胞这一假说。显然需要更好地了解这种肿瘤的组织发生。