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脑室外神经细胞瘤:一项综述

Extraventricular neurocytoma, a comprehensive review.

作者信息

Patil Akshay S, Menon G, Easwer H V, Nair S

机构信息

Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences &Technology, Trivandrum, India, 695011,

出版信息

Acta Neurochir (Wien). 2014 Feb;156(2):349-54. doi: 10.1007/s00701-013-1971-y. Epub 2013 Dec 20.

Abstract

AIMS AND OBJECTIVE

Extra ventricular neurocytoms (EVN) are a rare parenchymal brain tumour distinct from central neurocytomas. This review attempts to analyze a series of seven cases of EVN from a single institute against the background of available literature.

METHOD

Retrospective analysis of the clinical manifestation, pathological features, imaging findings, microsurgical treatment effectiveness and progression free survival of seven cases of EVN operated between 2000-2012.

RESULTS

The study group included five females and two males in the age group 7-65 years (mean 30.71 yrs). The distribution of the lesion was as follows Lobar 4, Cerebellum 1, Pineal 1, spinal 1. The duration of clinical symptoms ranged from three months to seven years and the presentation was site and size specific. Cystic Changes (71 %), perilesional oedema (57 %) and heterogeneous contrast enhancement (85.7 %), and calcification (42 %) were a few distinct imaging characteristics. Increased perfusion correlated with atypical histology in two patients. Surgical resection remains the main management strategy for longer outcome and patients with STR + RT and GTR had comparable follow-up. Extremes of age and atypical histological features were adverse prognostic factors.

CONCLUSION

EVN are rare tumors with either glial or neuronal differentiation or a potential for atypical changes. Both, GTR and STR combined with RT, offer reasonably good outcome with overall comparable survival. The available literature of EVN is limited, larger series with long term follow-ups are needed to dictate the management protocol. The role of adjuvant therapy is still debatable and needs further validation.

摘要

目的

脑室外神经细胞瘤(EVN)是一种罕见的脑实质肿瘤,与中枢神经细胞瘤不同。本综述试图在现有文献的背景下,分析来自单一机构的7例EVN病例。

方法

回顾性分析2000年至2012年间接受手术的7例EVN患者的临床表现、病理特征、影像学表现、显微手术治疗效果和无进展生存期。

结果

研究组包括5名女性和2名男性,年龄在7至65岁之间(平均30.71岁)。病变分布如下:脑叶4例,小脑1例,松果体1例,脊髓1例。临床症状持续时间从3个月到7年不等,表现因部位和大小而异。囊性改变(71%)、瘤周水肿(57%)、不均匀强化(85.7%)和钙化(42%)是一些明显的影像学特征。两名患者灌注增加与非典型组织学相关。手术切除仍然是获得更长生存期的主要治疗策略,接受次全切除(STR)+放疗(RT)和全切(GTR)的患者随访情况相当。年龄极端情况和非典型组织学特征是不良预后因素。

结论

EVN是罕见肿瘤,具有神经胶质或神经元分化或非典型改变的可能性。GTR和STR联合RT均能提供相当好的预后,总体生存率相当。EVN的现有文献有限,需要更大规模的长期随访系列研究来确定治疗方案。辅助治疗的作用仍有争议,需要进一步验证。

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