Cohen Alan R, Vogel Timothy W, Lidov Hart G W
Departments of Neurosurgery and.
J Neurosurg Pediatr. 2013 Dec;12(6):642-54. doi: 10.3171/2013.8.PEDS1377. Epub 2013 Sep 27.
The authors describe an 8-year-old girl who underwent emergency posterior fossa surgery for resection of a large cerebellar astrocytoma in November 1939. The surgery was carried out by Franc D. Ingraham at Boston Children's Hospital a decade after he established the first pediatric neurosurgical service in the world at the same institution. Four years later the tumor recurred and the patient underwent repeat resection followed by external-beam radiation therapy. The pathological diagnosis by Sidney Farber was fibrillary astrocytoma. The young girl is currently a healthy, functional 82-year-old woman. The authors believe that this 74-year follow-up represents one of the longest in history, if not the longest, of a patient undergoing resection of a brain tumor. A recent MRI study shows postoperative changes with no evidence of residual or recurrent tumor. The original block tissue specimen had been preserved. It was restained and examined, revealing the pathological diagnosis to be juvenile pilocytic astrocytoma. The case is analyzed in the context of Ingraham's powerful and lasting impact on the field of pediatric neurosurgery.
作者描述了一名8岁女孩，她于1939年11月接受了紧急后颅窝手术，以切除一个巨大的小脑星形细胞瘤。该手术由弗朗克·D·英格拉汉姆在波士顿儿童医院进行，这是他在同一机构建立世界上首个儿科神经外科服务十年之后。四年后肿瘤复发，患者接受了再次切除，随后进行了外照射放疗。西德尼·法伯做出的病理诊断为纤维型星形细胞瘤。这位年轻女孩如今已是一位健康、功能正常的82岁女性。作者认为，这74年的随访即便不是脑肿瘤切除患者历史上最长的随访，也是历时最长的随访之一。最近的一项MRI研究显示有术后改变，但没有残留或复发肿瘤的迹象。原始的块状组织标本一直保存着。对其进行了重新染色和检查，结果显示病理诊断为青少年毛细胞型星形细胞瘤。本文结合英格拉汉姆对儿科神经外科领域强大而持久的影响对该病例进行了分析。
