Kitchen William John, Pizer Barry, Pettorini Benedetta, Husband David, Mallucci Conor, Jenkinson Michael D
Department of Neurosurgery, Walton Centre NHS Foundation Trust, Liverpool, UK.
Pediatr Neurosurg. 2015;50(2):68-72. doi: 10.1159/000380856. Epub 2015 Apr 10.
Ependymoma is the third most common intracranial glioma in children. The treatment of choice for these tumours remains gross total resection followed by radiotherapy. There are two principal histological subtypes, namely classic (∼70%) and anaplastic (∼30%) ependymoma.
We present the case of a 12-year-old girl with an anaplastic ependymoma of the left temporal lobe. She underwent initial image-guided resection following biopsy. A postoperative MRI showed a macroscopic resection. She subsequently relapsed and indeed had 11 local and distant relapses managed by 12 separate craniotomies and tumour resection, 4 courses of radiotherapy and chemotherapy.
For patients with multiple relapses, surgery should be considered primarily to re-resect any symptomatic lesion. This case demonstrates that multiple tumour resections can be undertaken with limited morbidity for the patient and with maintenance of quality of life. Repeated focal irradiation can also be used to control the disease with limited morbidity.
室管膜瘤是儿童第三常见的颅内胶质瘤。这些肿瘤的首选治疗方法仍然是全切除，随后进行放疗。有两种主要的组织学亚型，即经典型（约70%）和间变型（约30%）室管膜瘤。
我们报告一例12岁左侧颞叶间变型室管膜瘤女孩的病例。活检后她接受了初步的影像引导下切除术。术后MRI显示为大体切除。她随后复发，实际上有11次局部和远处复发，通过12次单独的开颅手术和肿瘤切除术、4个疗程的放疗和化疗进行处理。
对于多次复发的患者，应首先考虑手术以再次切除任何有症状的病变。该病例表明，多次肿瘤切除对患者的发病率有限，且能维持生活质量。重复局部照射也可用于控制疾病，发病率有限。
