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恶性胶质瘤经脑室-腹腔分流管发生神经外转移:以腹水形式在腹腔内生长

[Extraneural metastasis of malignant glioma through a ventriculo-peritoneal shunt: growth in peritoneal cavity as ascitic form].

作者信息

Wakabayashi T, Yoshida J, Kageyama N, Mutsuga N, Takeuchi Y

出版信息

No Shinkei Geka. 1985 May;13(5):547-52.

PMID:2991792
Abstract

This is the first report of extraneural metastasis of malignant glioma through V-P shunt tube and growth in peritoneal cavity as ascitic form. The patient was a 43-year-old man who was admitted to our hospital with occipital headache. CT scan showed enhanced cystic tumor mass at left temporal lobe. Craniotomy and partial excision of the tumor was done and the histology of tumor tissue showed a malignant astrocytoma. Following this treatment, the patient received the adjuvant therapies of radiation, chemotherapy and immunotherapy with interferon, and also recraniotomy three times. In the mean time, a ventriculo-peritoneal shunt was set up for internal hydrocephalus. One month later, abdominal bulging appeared and yellowish ascites could be obtained with peritoneal tap. In the ascite, tumor cells with glial fibrillary acidic protein were observed at the concentration of 5-10 x 10(4) cells/ml. The patient died three months after extraneural metastasis to the abdominal cavity as ascitic form. At autopsy, solid metastatic mass lesion was not found in extraneural region include abdomen.

摘要

这是关于恶性胶质瘤通过脑室-腹腔分流管发生神经外转移并以腹水形式在腹腔内生长的首例报告。患者为一名43岁男性,因枕部头痛入院。CT扫描显示左颞叶有强化的囊性肿瘤肿块。行开颅手术并部分切除肿瘤,肿瘤组织的组织学检查显示为恶性星形细胞瘤。此次治疗后,患者接受了放疗、化疗以及干扰素免疫治疗等辅助治疗,还进行了三次再次开颅手术。与此同时,因脑积水置入了脑室-腹腔分流管。一个月后,患者出现腹部膨隆,腹腔穿刺可获取淡黄色腹水。在腹水中,观察到含有胶质纤维酸性蛋白的肿瘤细胞,浓度为5 - 10×10⁴个细胞/毫升。患者在以腹水形式发生腹腔神经外转移三个月后死亡。尸检时,在包括腹部在内的神经外区域未发现实体性转移肿块病变。

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