Department of Neurosurgery, Faculty of Medicine, University of Dicle, 21280, Diyarbakır, Turkey - Email:
Arch Ital Biol. 2020 Dec 1;158(3-4):74-81. doi: 10.12871/000398292020342.
Posterior fossa tumors (PFTs) include medulloblastomas, atypical teratoid/rhabdoid tumors, pilocytic astrocytomas, ependymomas, and brainstem gliomas. We evaluated patients with surgery at our clinic, comparing epidemiological, clinical, radiological, and pathological characteristics of medulloblastoma and ependymoma to identify factors that might assist preoperative diagnosis, help to develop treatment algorithms, and have prognostic value after surgery. Pediatric patients from 0 to 16 and young adults from 16 to 29 years of age with surgery for pathologically confirmed ependymomas or medulloblastomas between January 2014 and January 2020 were eligible. The study included 19 patients, seven with ependymoma (37%) and 12 with medulloblastoma (63.2%). The ependymoma patients were 5.29 ± 5.85 years of age, the medulloblastoma patients were 11.58 ± 8.17 years of age, and 16 patients (84%) were children.Fifteen patients (79%) presented with signs of increased intracranial pressure and four (21%) presented with cerebellar findings. MRI found that 74% (14) of the PSTs were located in the midline, including six of the seven ependymomas (86%) and eight of the 12 medulloblastomas (67%). Enhancement was significantly greater in medulloblastomas compared with ependymomas (p = 0.022). In according to pathology results; synaptophysin, NSE, chromogranin and 50% GFAP positivity were observed in medulloblastoma. Ependymomas were S100 (43%) and vimentin (29%) positive. Ependymoma patients were younger than medulloblastoma patients and more were female. There were no significant differences in the clinical findings, but ependymomas were larger and had greater rates of enhancement and spinal metastasis compared with medulloblastomas.
后颅窝肿瘤（PFTs）包括髓母细胞瘤、非典型畸胎瘤/横纹肌样瘤、毛细胞星形细胞瘤、室管膜瘤和脑干胶质瘤。我们评估了在我们诊所接受手术的患者，比较了髓母细胞瘤和室管膜瘤的流行病学、临床、影像学和病理学特征，以确定可能有助于术前诊断的因素，帮助制定治疗方案，并在手术后具有预后价值。2014 年 1 月至 2020 年 1 月期间，有手术病理证实的室管膜瘤或髓母细胞瘤的 0 至 16 岁儿童和 16 至 29 岁年轻成人患者符合入选条件。研究纳入 19 例患者，其中 7 例为室管膜瘤（37%），12 例为髓母细胞瘤（63.2%）。室管膜瘤患者年龄为 5.29 ± 5.85 岁，髓母细胞瘤患者年龄为 11.58 ± 8.17 岁，16 例（84%）为儿童。15 例（79%）患者有颅内压增高的体征，4 例（21%）患者有小脑体征。MRI 发现 74%（14 例）的 PSTs 位于中线，其中 7 例室管膜瘤中的 6 例（86%）和 12 例髓母细胞瘤中的 8 例（67%）。髓母细胞瘤的强化程度明显高于室管膜瘤（p = 0.022）。根据病理结果；髓母细胞瘤中观察到突触素、NSE、嗜铬粒蛋白和 50%GFAP 阳性，室管膜瘤中 S100（43%）和波形蛋白（29%）阳性。室管膜瘤患者比髓母细胞瘤患者年轻，且女性更多。临床发现无显著差异，但室管膜瘤比髓母细胞瘤更大，强化程度更高，且脊髓转移率更高。
