Rohrlich P, Hartmann O, Couanet D, Caillaud J M, Valteau D, Brugières L, Kalifa C, Lemerle J
Département de Pédiatrie, Institut Gustave-Roussy, Villejuif.
Arch Fr Pediatr. 1989 Jan;46(1):5-10.
In order to evaluate the frequency, clinical and radiological aspects and prognosis of central nervous system metastases in children's neuroblastoma, the 258 children presenting with neuroblastoma, and registered from January 1982 to August 1987, were studied. Among them, 7 patients (2.7%), of which 6 had an initially metastatic neuroblastoma, presented with a secondary neuro-meningeal involvement. Parenchyma involvement (4 cases) occurred after a mean period of time of 21 months and marked the relapses. The disease recurs later on, even when locally controlled by surgical excision and local irradiation. Meningeal involvements (3 cases) occurred after a mean delay of 12.7 months, in patients with full tumoral evolutivity, and were responsible for rapid death. The clinical presentation of these metastases differs from that in adults by the rapidity of setting up of the signs and the frequency of intracranial hypertension. CT scan allows approaching diagnosis in the majority of the cases. These data are compared with those in the literature, where 30 cases were reported: they show a high patients' average age and the worse prognosis.
为评估儿童神经母细胞瘤中枢神经系统转移的发生率、临床和放射学特征及预后，对1982年1月至1987年8月登记的258例患神经母细胞瘤的儿童进行了研究。其中7例（2.7%）出现继发性神经脑膜受累，其中6例最初为转移性神经母细胞瘤。实质受累（4例）平均在21个月后出现，标志着复发。即使通过手术切除和局部放疗实现局部控制，疾病仍会在后期复发。脑膜受累（3例）平均延迟12.7个月出现，见于肿瘤完全进展的患者，是导致快速死亡的原因。这些转移瘤的临床表现与成人不同，表现为症状出现迅速和颅内高压发生率高。多数情况下，CT扫描有助于做出诊断。将这些数据与文献报道的30例病例进行比较：文献显示患者平均年龄较大且预后较差。
