Lakhdar Fayçal, Benzagmout Mohammed, Arkha Yasser, Chakour Khalid, Chaoui Mohammed El Faiz
Department of Neurosurgery, Hassan II Hospital, University Sidi Mohammed Ben Abdellah, Fez, Morocco.
Department of Neurosurgery, Hopital des Spéciaités, University Mohammed V of Medecine, Rabat, Morocco.
Asian J Neurosurg. 2020 Feb 25;15(1):225-229. doi: 10.4103/ajns.AJNS_128_19. eCollection 2020 Jan-Mar.
Atypical teratoid/rhabdoid tumors (AT/RTs) of infancy are highly malignant central nervous system neoplasms that are most commonly seen during the first 2 years of life with limited therapeutic options. To date, only two cases have been described in the lateral ventricle. A 4-year-old boy presented with a 4-month history of increased intracranial pressure. Cerebral magnetic resonance imaging (MRI) revealed a huge intraventricular tumor, occupying the entire temporal horn and the body of the left lateral ventricle. The boy was operated through a left temporal transventricular approach with gross total removal of the lesion. The histopathological diagnosis was an AT/RT. The infant underwent adjuvant chemotherapy and radiation therapy. The 1-year MRI of control showed a local recurrence of the tumor. Then after, Gamma Knife radiosurgery was performed because of the small volume and the deep location of the lesion. At the 3-month follow-up, the MRI showed a significant growth of the tumor volume, and the child was given additional adjuvant chemotherapy. Unfortunately, he died 9 months later. AT/RT of the lateral ventricle is a very rare tumor in children, associated with a poor prognosis in spite of multimodal treatment. Gamma knife surgery (GKS) was rarely reported as a treatment modality of AT/RT. The aim of this work is to discuss about the rarity of this tumor and the best treatment strategy to improve prognosis.
婴儿非典型畸胎样/横纹肌样肿瘤(AT/RTs)是高度恶性的中枢神经系统肿瘤,最常见于生命的头两年,治疗选择有限。迄今为止,仅报道过两例侧脑室AT/RTs。一名4岁男孩有4个月颅内压升高病史。脑部磁共振成像(MRI)显示一个巨大的脑室内肿瘤,占据整个颞角和左侧脑室体部。该男孩通过左颞经脑室入路手术,肿瘤被大体全切。组织病理学诊断为AT/RT。该患儿接受了辅助化疗和放射治疗。术后1年的MRI复查显示肿瘤局部复发。此后,由于肿瘤体积小且位置深,进行了伽玛刀放射外科治疗。在3个月的随访中,MRI显示肿瘤体积显著增大,患儿接受了额外的辅助化疗。不幸的是,他9个月后死亡。侧脑室AT/RT在儿童中是一种非常罕见的肿瘤,尽管采用了多模式治疗,预后仍然很差。伽玛刀手术(GKS)作为AT/RT的一种治疗方式鲜有报道。本文旨在探讨该肿瘤的罕见性及改善预后的最佳治疗策略。