Choque-Velasquez Joham, Resendiz-Nieves Julio C, Jahromi Behnam Rezai, Colasanti Roberto, Raj Rahul, Tynninen Olli, Collan Juhani, Hernesniemi Juha
Department of Neurosurgery, Helsinki University Hospital, University of Helsinki and HUSLAB, Helsinki, Finland.
Department of Neurosurgery, Helsinki University Hospital, University of Helsinki and HUSLAB, Helsinki, Finland.
World Neurosurg. 2019 Feb;122:e729-e739. doi: 10.1016/j.wneu.2018.10.128. Epub 2018 Nov 1.
Pineal parenchymal tumors of intermediate differentiation (PPTIDs) are rare lesions with particular features compared with other pineal parenchymal tumors.
We present a retrospective review of patients with histologically confirmed PPTIDs who were operated on in our department between 1997 and 2015. A demographic analysis and an evaluation of preoperative status, surgical treatment, as well as immediate and long-term clinical and radiologic outcomes were conducted.
Fifteen patients with PPTIDs were operated on between 1997 and 2015. Gross total removal was achieved in 11 cases; 2 patients underwent near-total resection, 1 partial resection, and 1 received brachytherapy after an endoscopic biopsy. Nine patients required external radiation therapy (4 due to a pleomorphic histology of their lesion including pineoblastoma features in 3 of them; 3 after a subtotal resection; and 2 for tumor recurrence). No patient received chemotherapy. The survival rate of our patients was 57.1% at a mean follow-up of 137.2 ± 77.6 months (39-248 months).
A proper multidisciplinary management of PPTIDs based on a gross total removal of the lesion, and an adjuvant radiotherapy in selected cases, may improve the overall survival of these aggressive tumors.
与其他松果体实质肿瘤相比,中间分化型松果体实质肿瘤(PPTIDs)是具有特殊特征的罕见病变。
我们对1997年至2015年在我科接受手术治疗且组织学确诊为PPTIDs的患者进行了回顾性研究。进行了人口统计学分析,并对术前状态、手术治疗以及近期和长期临床及影像学结果进行了评估。
1997年至2015年期间,15例PPTIDs患者接受了手术治疗。11例实现了肿瘤全切;2例患者接受了近全切,1例接受了部分切除,1例在内镜活检后接受了近距离放疗。9例患者需要接受外照射放疗(4例是因为其病变具有多形性组织学特征,其中3例具有松果体母细胞瘤特征;3例在次全切除后;2例因肿瘤复发)。没有患者接受化疗。平均随访137.2±77.6个月(39 - 248个月)时,我们患者的生存率为57.1%。
基于病变的全切以及在选定病例中进行辅助放疗,对PPTIDs进行适当的多学科管理,可能会提高这些侵袭性肿瘤的总体生存率。