Department of Neurosurgery, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Korea.
Acta Neurochir (Wien). 2012 Nov;154(11):1961-71; discussion 1972. doi: 10.1007/s00701-012-1490-2. Epub 2012 Sep 5.
Central neurocytomas (CN) are rare intraventricular tumors with benign clinical behavior that typically affect young adults. Although a favorable prognosis is generally expected after adequate management, there is no general consensus on the standard of therapy. We evaluated the efficacy and safety of radical surgery for the management of CN.
Between 1996 and 2010, 12 patients with CN (eight males and four females; range, 18 to 62 years; mean age, 28.5 years) were surgically treated in our institution. The initial goal of therapy was complete resection through a frontal transcortical approach, and repeat surgery was done in cases of residual or recurrent disease. The mean follow-up period was 51.2 months (range, 14-149 months).
Complete resection was achieved in all patients either with primary (nine patients, 75 %) or second-look surgery (three patients, 25 %). No mortalities occurred and there were four surgery-related complications (two events of transient hemiparesis, one transient aphasia, and onepostoperative subdural hygroma). All patients were alive with normal activities of daily living at the last follow-up. Two patients (16.6 %) experienced a single recurrence at 26 and 66 months, one of whom underwent redo-surgery.
For the management of CN, complete resection is feasible, effective, and safe. Repeat surgery may be a viable option in cases of residual or recurrent disease and the use of radiotherapy can be avoided in this young population.
中枢神经细胞瘤(CN)是一种罕见的脑室肿瘤,具有良性的临床行为,通常影响年轻人。尽管在适当的治疗后通常预期预后良好,但对于治疗标准尚无共识。我们评估了根治性手术治疗 CN 的疗效和安全性。
1996 年至 2010 年间,我们机构共治疗了 12 例 CN 患者(8 名男性,4 名女性;年龄 18 至 62 岁;平均年龄 28.5 岁)。治疗的初始目标是通过额皮质切开术进行完全切除,如果有残留或复发疾病,则进行重复手术。平均随访时间为 51.2 个月(范围 14-149 个月)。
所有患者均通过初次手术(9 例,75%)或二次手术(3 例,25%)实现了完全切除。无死亡病例,有 4 例手术相关并发症(2 例短暂偏瘫,1 例短暂失语,1 例术后硬膜下积气)。所有患者在最后一次随访时均存活且日常生活活动正常。2 例患者(16.6%)分别在 26 个月和 66 个月时出现单发复发,其中 1 例再次手术。
对于 CN 的治疗,完全切除是可行的、有效的且安全的。在残留或复发疾病的情况下,重复手术可能是一种可行的选择,并且可以避免在这个年轻人群中使用放疗。