Tsutsumi Satoshi, Yasumoto Yukimasa, Ito Masanori
Department of Neurological Surgery, Juntendo University Urayasu Hospital, Tomioka, Urayasu, Japan.
J Clin Neurosci. 2009 Aug;16(8):1086-8. doi: 10.1016/j.jocn.2008.07.089. Epub 2009 May 5.
An 8-year-old girl with no family history of neoplasia underwent biopsy and chemoradiation therapy for a suprasellar mixed germ cell tumor, which resulted in complete remission. A surveillance MRI taken 37 months after irradiation detected a non-enhancing mass in the genu of the corpus callosum. MRI taken 42 months after irradiation revealed significant growth of the mass and a new enhancing lesion in the temporal lobe, which showed rapid growth over 3 weeks. Subtotal resection and biopsy were performed on the lesions in the temporal lobe and the corpus callosum, respectively. Histological examination revealed that the temporal tumor was a glioblastoma multiforme and the frontal lesion was a diffuse astrocytoma. These tumors had newly developed within the irradiated field, but were separated in both location and time. Radiation-induced gliomas may develop within a shorter time interval than previously considered.
一名无肿瘤家族史的8岁女孩因鞍上混合性生殖细胞肿瘤接受了活检和放化疗，治疗后完全缓解。放疗37个月后进行的监测MRI检查发现胼胝体膝部有一个无强化肿块。放疗42个月后进行的MRI检查显示该肿块显著增大，且颞叶出现一个新的强化病灶，该病灶在3周内迅速生长。分别对颞叶和胼胝体的病灶进行了次全切除和活检。组织学检查显示，颞叶肿瘤为多形性胶质母细胞瘤，额叶病灶为弥漫性星形细胞瘤。这些肿瘤在放疗区域内新发生，但在位置和时间上均相互分离。辐射诱发的胶质瘤可能在比之前认为的更短时间间隔内发生。
