Ryzhova M V, Zheludkova O G, Ozerov S S, Shishkina L V, Panina T N, Gorelyshev S K, Novikov A I, Melikian A G, Kushel' Iu V, Korshunov A E
Zh Vopr Neirokhir Im N N Burdenko. 2011;75(4):25-33; discussion 33.
Embryonic tumor with abundant neuropil and true rosettes (ETANTR) is a very aggressive rare tumor with unique histologic and molecular features occurring in very young children. At present approximately 80 cases of ETANTR have been documented in the literature since first description in 2000. We report seven patients with ETANTR below 4 years of age who underwent surgical resection in the Burdenko Neurosurgery Institute between 2005 and 2010. Four children have received different modality chemotherapy and radiotherapy and two patients were treated by chemotherapy alone. One child did not receive any adjuvant treatment. All children had local relapses, two of them were operated twice. A 2 year old girl underwent subtotal resection thrice. Histological examination showed that all tumors were composed of true multilayered rosettes admixed with large areas of paucicellular neuropil. By analysis of recurrences we have found that large areas of neuropil and number of true rosettes were lost and tumors acquired a resemblance to central nervous system primitive neuroectodermal tumors. In four cases frozen tumor material was available for array-based comparative genomic hybridization, which discovered trisomy of chromosome 2 and amplification at the 19q13.42 chromosome locus. Fluorescence in situ hybridization revealed amplification at the 19q13.42 chromosome locus in all cases.
伴有丰富神经纤维网和真性菊形团的胚胎性肿瘤(ETANTR)是一种侵袭性很强的罕见肿瘤,具有独特的组织学和分子特征,多见于幼儿。自2000年首次描述以来,目前文献中已记录了约80例ETANTR。我们报告了2005年至2010年间在布尔坚科神经外科研究所接受手术切除的7例4岁以下ETANTR患者。4名儿童接受了不同方式的化疗和放疗,2名患者仅接受化疗。1名儿童未接受任何辅助治疗。所有儿童均出现局部复发,其中2人接受了二次手术。一名2岁女孩接受了三次次全切除。组织学检查显示,所有肿瘤均由真性多层菊形团组成,并伴有大片少细胞神经纤维网。通过对复发情况的分析,我们发现大片神经纤维网和真性菊形团数量减少,肿瘤与中枢神经系统原始神经外胚层肿瘤相似。4例患者有冷冻肿瘤材料可用于基于芯片的比较基因组杂交,结果发现2号染色体三体以及19q13.42染色体位点扩增。荧光原位杂交显示所有病例中19q13.42染色体位点均有扩增。