Hu W, Shen F, Chen G, Shen G, Liu W, Zhou J
Department of Neurosurgery, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
J Int Med Res. 2009 Jan-Feb;37(1):240-6. doi: 10.1177/147323000903700129.
The case of a 62-year old man diagnosed with radiation-induced meningioma (RIM) after treatment for astrocytoma with an unusually short latency period of 7 months is reported. The patient first presented with a 2-month history of memory decline. Magnetic resonance imaging (MRI) showed a tumour in the left parieto-temporal lobe. Gross total resection was performed and the tumour was confirmed to be an astrocytoma. The patient received cranial radiotherapy 2 weeks later, however 7 months after radiation treatment the patient presented with headache and vomiting. MRI showed massive meningeal enhancement in the left frontal lobe, which progressively enlarged. The patient's clinical condition deteriorated and a second craniotomy was performed with complete removal of the secondary tumour, which was shown to be a malignant meningioma. Immunohistochemical staining identified CD133-positive cells in both tumours. A rare fraction of brain tumour stem cells (BTSC) was isolated from the primary astrocytoma using a serum-free culture system, suggesting that BTSC may have been involved in the rapid emergence of RIM after resection and radiation of the primary astrocytoma.
报告了一例62岁男性患者，其在接受星形细胞瘤治疗后7个月的异常短潜伏期被诊断为放射性诱导性脑膜瘤（RIM）。患者最初表现为2个月的记忆力减退病史。磁共振成像（MRI）显示左颞顶叶有一个肿瘤。进行了肿瘤全切除，肿瘤被确诊为星形细胞瘤。患者在2周后接受了颅脑放疗，然而放疗7个月后患者出现头痛和呕吐。MRI显示左额叶有大量脑膜强化，且逐渐增大。患者的临床状况恶化，进行了第二次开颅手术，完全切除了继发性肿瘤，结果显示为恶性脑膜瘤。免疫组织化学染色在两个肿瘤中均鉴定出CD133阳性细胞。使用无血清培养系统从原发性星形细胞瘤中分离出了罕见的一部分脑肿瘤干细胞（BTSC），这表明BTSC可能参与了原发性星形细胞瘤切除和放疗后RIM的快速出现。
