Simal-Julián J A, Sanchis-Martín R, Prat-Acín R, Miranda-Lloret P, Conde-Sardón R, Cárdenas-Ruiz-Valdepeñas E, Beltrán-Giner A
Servicio de Neurocirugía Hospital La Fe de Valencia, España.
Neurocirugia (Astur). 2010 Oct;21(5):390-5. doi: 10.4321/s1130-14732010000500004.
we report the clinical, radiological and pathological features of a spinal pleomorphic xanthoastrocytoma, an unusual neoplastic entity in a really rare location, establish an appropriated management of these lesions and review the short available english literature.
a 60 years old woman consulted with doctor because she felt progressive clumsiness accompanied by occasional paresthesias on her left hand. Neurological examination showed up weakness and slight propioceptive disturbances. The differential imagine diagnosis was established between intramedullary astrocytoma and ependimoma. Patient underwent surgical gross total remove. Histopathological examination confirmed the diagnosis of pleomorfic xanthoastrocytoma. We performed MRI controls at 6, 12, 24 and 36 months that did not reveal recurrence. Nowadays, the patient has regained her previous quality of life.
comparing to published cases about intracranial pleomorphic xanthoastrocytomas, spinal pleomorphic xanthoastrocytomas (SPXA) present different epidemiological characteristics. The known SPXAs affected to cervical and/or high thoracic levels. The hypothesis about a more aggressive behaviour of PXA in spinal cord may be corroborated after literature review. Extension examination is mandatory since dissemination along the neuroaxis has been described. Removal extension is crucial in the prevention of tumour recurrence. Adyuvant radiotherapy should only be considered when there is postoperative residual tumour and/or anaplastic features. Randomized clinical trials or databases are necessary to know all the aspects of this pathological entity.
我们报告了一例脊髓多形性黄色星形细胞瘤的临床、放射学和病理学特征，这是一种发生在极为罕见部位的不寻常肿瘤实体，确立了对这些病变的适当管理方法，并回顾了现有的简短英文文献。
一名60岁女性因左手渐进性笨拙并伴有偶尔的感觉异常而咨询医生。神经学检查显示有无力和轻微的本体感觉障碍。在髓内星形细胞瘤和室管膜瘤之间进行了鉴别影像学诊断。患者接受了手术全切。组织病理学检查确诊为多形性黄色星形细胞瘤。我们在6个月、12个月、24个月和36个月时进行了MRI检查，未发现复发。如今，患者已恢复到之前的生活质量。
与已发表的关于颅内多形性黄色星形细胞瘤的病例相比，脊髓多形性黄色星形细胞瘤（SPXA）呈现出不同的流行病学特征。已知的SPXA累及颈椎和/或上胸段水平。经文献回顾后，关于PXA在脊髓中行为更具侵袭性的假设可能得到证实。由于已描述有沿神经轴扩散的情况，所以必须进行广泛检查。切除范围对于预防肿瘤复发至关重要。仅在术后有残留肿瘤和/或间变特征时才应考虑辅助放疗。需要进行随机临床试验或数据库研究以了解该病理实体的所有方面。
