Nizolin D V, Fedorov E V, Kim A V, Mitrofanova L B, Khachatryan V A
Almazov National Medical Research Center, St. Petersburg, Russia.
Zh Vopr Neirokhir Im N N Burdenko. 2021;85(2):80-90. doi: 10.17116/neiro20218502180.
Multiple gliomas are determined by synchronous two or more tumors located in different brain regions. It is important to distinguish multiple primary tumors and metastatic brain lesion. In the first case, tumor spread can`t be explained by dissemination along the cerebrospinal fluid pathways, commissural fibers or local metastases. Multiple primary tumors with different histological structures are called bidermal neoplasms. Surgery is preferred in these patients with severe symptoms. The purpose of surgery is maximum resection of tumor. Follow-up may be advisable for small tumors without clinical manifestations. Treatment of multiple gliomas includes surgery, radiotherapy and chemotherapy. Multiple tumor process in children is much more severe compared to a single neoplasia that requires neurological and neuroimaging control and determines treatment strategy. The authors report 3 children with multicentric gliomas, discuss the various aspects of diagnosis and treatment of multiple gliomas and formulate the recommendations for the treatment based on own clinical experience and literature data.
多发性胶质瘤由位于不同脑区的两个或更多同步肿瘤所确定。区分多原发性肿瘤和脑转移瘤很重要。在第一种情况下，肿瘤扩散无法通过沿脑脊液通路、连合纤维或局部转移来解释。具有不同组织结构的多原发性肿瘤被称为双胚层肿瘤。对于有严重症状的这些患者，手术是首选。手术的目的是最大程度切除肿瘤。对于无临床表现的小肿瘤，随访可能是可取的。多发性胶质瘤的治疗包括手术、放疗和化疗。与单一肿瘤相比，儿童的多肿瘤进程要严重得多，这需要神经学和神经影像学监测并确定治疗策略。作者报告了3例多中心胶质瘤患儿，讨论了多发性胶质瘤诊断和治疗的各个方面，并根据自身临床经验和文献数据制定了治疗建议。
