Wang Jing, Jia Jianwu, Hou Zhaoyuan, Yuan Xunhui, Sun Gaoling, Niu Jianyi, Li Zhiping
Department of Neurosurgery, Yidu Central Hospital of Weifang.
Department of Neurology, Qingzhou People's Hospital.
J Craniofac Surg. 2018 Jul;29(5):e499-e502. doi: 10.1097/SCS.0000000000004543.
Optic pathway hypothalamic gliomas are intrinsic low-grade gliomas involving the optic nerve, chiasm, optic tract, and hypothalamus. The rarity of these tumors and their unpredictable course make assessment and standardization of treatment modalities difficult. Tumor debulking via various transcranial approaches was considered to be effective at controlling tumor growth, but with high rates of severe surgery-related complications. In the present case, endoscopic transsphenoidal surgery was initiated to debulk the exophytic chiasmatic/hypothalamic glioma with good preservation of hypothalamic and endocrine functions. The authors suggest transsphenoidal surgery with tumor debulking could be an effective and safe treatment for patients with chiasmatic/hypothalamic gliomas.
视路下丘脑胶质瘤是累及视神经、视交叉、视束和下丘脑的原发性低级别胶质瘤。这些肿瘤的罕见性及其不可预测的病程使得治疗方式的评估和标准化变得困难。通过各种经颅入路进行肿瘤切除被认为对控制肿瘤生长有效，但手术相关严重并发症的发生率很高。在本病例中，采用内镜经蝶窦手术切除向鞍上生长的视交叉/下丘脑胶质瘤，同时很好地保留了下丘脑和内分泌功能。作者认为，经蝶窦肿瘤切除手术对于视交叉/下丘脑胶质瘤患者可能是一种有效且安全的治疗方法。
