Lu Runchun, Li Chuzhong, Wang Xinsheng, Zhang Yazhuo
Neurosurgical Department, Peking University First Hospital, Beijing, China.
Beijing Neurosurgical Institute, Beijing, China.
J Korean Neurosurg Soc. 2017 May;60(3):375-379. doi: 10.3340/jkns.2014.0808.026. Epub 2017 May 1.
Midbrain gliomas are relatively rare neoplasms with a generally benign prognosis, with dissemination or metastasis not previously reported. We describe here a woman, in whom magnetic resonance imaging scans showed hydrocephalus and a tegmental lesion in the upper aqueduct. Endoscopic third ventriculostomy and biopsy were performed; during surgery, a second small lesion was observed in the infundibular recess. Histologically, the two lesions had the characteristics of low grade astrocytoma, suggesting that the midbrain astrocytoma may have been disseminated via the cerebral spinal fluid to the infundibular recess. Postoperatively this patient received radiotherapy for nearly one month. Although patients with these tumors are not usually administered adjunctive therapy, radiation and, combined modality therapy, including surgery, radiotherapy, and chemotherapy, may be beneficial in patients with midbrain gliomas with dissemination.
中脑胶质瘤是相对罕见的肿瘤，总体预后一般为良性，此前未报告过有播散或转移情况。我们在此描述一名女性，其磁共振成像扫描显示脑积水以及中脑导水管上部的被盖部病变。进行了内镜下第三脑室造瘘术和活检；手术过程中，在漏斗隐窝观察到另一个小病变。组织学检查显示，这两个病变具有低级别星形细胞瘤的特征，提示中脑星形细胞瘤可能已通过脑脊液播散至漏斗隐窝。该患者术后接受了近一个月的放疗。尽管通常不给这些肿瘤患者进行辅助治疗，但对于有播散的中脑胶质瘤患者，放疗以及包括手术、放疗和化疗在内的综合治疗可能有益。
