Huang Xiang, Zhang Rong, Zhou Liang-Fu
Department of Neurosurgery, Huashan Hospital, and Department of Neurosurgery, Shanghai Medical College, Fudan University, Shanghai 200040, PR China.
Pediatr Neurosurg. 2009;45(5):354-60. doi: 10.1159/000257524. Epub 2009 Nov 11.
The purpose of this paper is toexplore the clinical features, treatment and prognosis of intracranial immature teratomas.
The clinical data, serum levels of tumor markers, treatment regimens and prognosis of 15 patients with intracranial immature teratomas were reviewed retrospectively.
In patients whose plasma alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (beta-HCG) were determined, AFP and beta-HCG were elevated in 57.1 and 16.7% of the cases, respectively. All patients received surgical treatment. The tumor was totally removed in 12 cases, subtotally in 2, and partially in 1 case. After surgery, of the 15 patients, 9 received radiotherapy, 4 gamma knife surgery and 7 chemotherapy. Thirteen patients were followed up. Compared to the common 5-year survival rate of 40%, in patients who received gamma knife surgery, the 5-year survival rate after surgery was 100%, which is better than the 5-year survival rate of patients who did not receive gamma knife surgery (p = 0.0049). Postoperative radiotherapy and chemical therapy had no significant impact on the 5-year survival rate (p > 0.05).
The prognosis of intracranial immature teratomas is poor. The detection of their clinical manifestation, the analysis of imaging features and the serum levels of tumor markers are helpful in diagnosing intracranial teratomas. The total removal of the tumor is important to cure the disease. We did not see a difference in outcome between patients who received postoperative chemotherapy or radiotherapy and those who did not. Regular follow-up MRI examinations are necessary so that the conditions of the patients can be closely monitored. If a patient has residual or recurrent tumor after surgery, gamma knife surgery can be effective.
本文旨在探讨颅内未成熟畸胎瘤的临床特征、治疗方法及预后。
回顾性分析15例颅内未成熟畸胎瘤患者的临床资料、肿瘤标志物血清水平、治疗方案及预后。
在检测血浆甲胎蛋白（AFP）和β-人绒毛膜促性腺激素（β-HCG）的患者中，AFP和β-HCG升高的病例分别占57.1%和16.7%。所有患者均接受了手术治疗。12例肿瘤完全切除，2例次全切除，1例部分切除。术后，15例患者中9例接受了放疗，4例接受了伽玛刀手术，7例接受了化疗。13例患者进行了随访。与常见的40%的5年生存率相比，接受伽玛刀手术的患者术后5年生存率为100%，优于未接受伽玛刀手术患者的5年生存率（p = 0.0049）。术后放疗和化疗对5年生存率无显著影响（p > 0.05）。
颅内未成熟畸胎瘤预后较差。对其临床表现的检测、影像学特征分析及肿瘤标志物血清水平有助于颅内畸胎瘤的诊断。肿瘤的完全切除对治愈疾病很重要。我们未发现术后接受化疗或放疗的患者与未接受者在预后上存在差异。定期进行MRI随访检查很有必要，以便密切监测患者病情。如果患者术后有肿瘤残留或复发，伽玛刀手术可能有效。
