Spena Giannantonio, Garbossa Diego, Barletta Laura, Prevost Chiara, Versari Pietro
Division of Neurosurgery, Civil Hospital, Alessandria, Italy.
Neurol Med Chir (Tokyo). 2010;50(5):410-3. doi: 10.2176/nmc.50.410.
A 38-year-old woman presented with a large infiltrative left frontal low-grade glioma manifesting as partial seizures of the left arm and lower limb. First line chemotherapy with temozolomide reduced infiltration and volume, allowing subtotal surgical resection. The patient suffered postoperative supplementary motor area syndrome with right hemiparesis and mutism that resolved completely after approximately one month. She was able to return to her full-time job after 4 months. The residual tumor was stable, and the frequency of seizures had lessened dramatically at the last follow-up examination at 18 months. The present case demonstrates that this new therapeutic approach of chemotherapy followed by surgery can offer safer and more radical surgical resection, improving the quality of life of the patient.
一名38岁女性因左额叶巨大浸润性低级别胶质瘤就诊,表现为左上肢和下肢部分性癫痫发作。采用替莫唑胺一线化疗可减少浸润并缩小肿瘤体积,从而得以进行次全手术切除。患者术后出现辅助运动区综合征,伴有右侧偏瘫和缄默症,约1个月后完全缓解。4个月后她能够重返全职工作。残留肿瘤稳定,在18个月的最后一次随访检查时癫痫发作频率显著降低。本病例表明,这种先化疗后手术的新治疗方法可提供更安全、更彻底的手术切除,改善患者生活质量。