Arcos Andrea, Romero Lorena, Serramito Ramón, Santín José M, Prieto Antonio, Gelabert Miguel, Arráez Miguel Ángel
Neurosurgery Service, Carlos Haya Regional University Hospital, Málaga, Spain.
Neurocirugia (Astur). 2012 Sep;23(5):211-5. doi: 10.1016/j.neucir.2012.06.004. Epub 2012 Jul 31.
Multicentric gliomas are uncommon lesions of the central nervous system. Their management remains controversial, but histopathologic diagnosis after complete or partial resection must be performed to differentiate these tumors from other multiple cerebral lesions. Three cases of multicentric glioma are presented, one of which had supra- and infratentorial lesions. Histological specimens were obtained from removal of at least one of the lesions. Neuropathological examinations confirmed the diagnosis of grade IV malignant glioma (glioblastoma). All 3 patients died soon after symptom onset. However, one patient, with metachronous glioblastomas, had a comparatively long survival. We discuss the pathogenetic hypotheses and the diagnostic problems, especially the differential diagnosis from other multifocal diseases of the central nervous system.
多中心胶质瘤是中枢神经系统的罕见病变。其治疗仍存在争议，但必须在完整或部分切除后进行组织病理学诊断，以将这些肿瘤与其他多发性脑病变区分开来。本文报告3例多中心胶质瘤病例，其中1例同时有幕上和幕下病变。从至少一个病变切除标本中获取组织学样本。神经病理学检查确诊为IV级恶性胶质瘤（胶质母细胞瘤）。所有3例患者均在症状出现后不久死亡。然而，1例患有异时性胶质母细胞瘤的患者存活时间相对较长。我们讨论了发病机制假说和诊断问题，尤其是与中枢神经系统其他多灶性疾病的鉴别诊断。
