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以脑积水为首发症状的弥漫性软脑膜神经胶质神经元肿瘤(DLGNT):基于病例的最新情况

Diffuse leptomeningeal glioneuronal tumour (DLGNT) with hydrocephalus as an initial symptom: a case-based update.

作者信息

Chen Wenlin, Kong Ziren, Fu Ji, Zhao Dachun, Wang Renzhi, Ma Wenbin, Wang Yu

机构信息

Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China.

Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China.

出版信息

Childs Nerv Syst. 2020 Mar;36(3):459-468. doi: 10.1007/s00381-019-04481-w. Epub 2020 Jan 2.

Abstract

PURPOSE

Diffuse leptomeningeal glioneuronal tumour (DLGNT) is a rare disease classified in 2016. There are different views of the clinical, pathologic and neuroradiologic characteristics of DLGNT due to the minor studies on this disease.

METHODS

We describe a case of a 12-year-old boy who initially presented intermittent headache, vomiting and communicating hydrocephalus. A literature review is also presented summarizing the clinical characteristics and treatments of DLGNT.

RESULTS

In our case, a ventriculoperitoneal shunt was applied to reduce intracranial pressure caused by communicating hydrocephalus. T1-weighted contrast-enhanced magnetic resonance imaging (MRI) showed linear enhancement, and microscopy showed tumour-like spindle cells. The diagnosis of DLGNT was confirmed, and temozolomide was administered. The clinical characteristics were similar in the reported cases, while the treatments showed differences.

CONCLUSION

Ventriculoperitoneal shunts are effective for patients with hydrocephalus-related intracranial hypertension. Chemotherapy including temozolomide has shown varying outcomes, and further studies are expected.

摘要

目的

弥漫性软脑膜神经胶质瘤(DLGNT)是2016年分类的一种罕见疾病。由于对该疾病的研究较少,对于DLGNT的临床、病理和神经放射学特征存在不同观点。

方法

我们描述了一名12岁男孩的病例,他最初表现为间歇性头痛、呕吐和交通性脑积水。还进行了文献综述,总结了DLGNT的临床特征和治疗方法。

结果

在我们的病例中,采用了脑室腹腔分流术来降低由交通性脑积水引起的颅内压。T1加权增强磁共振成像(MRI)显示线性强化,显微镜检查显示肿瘤样梭形细胞。DLGNT的诊断得到证实,并给予了替莫唑胺治疗。报告病例的临床特征相似,但治疗方法存在差异。

结论

脑室腹腔分流术对患有脑积水相关颅内高压的患者有效。包括替莫唑胺在内的化疗显示出不同的结果,期待进一步的研究。

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