岛叶成人毛细胞型星形细胞瘤：病例报告及文献复习
Adult Pilocytic Astrocytoma in the insula: Case report and review of the literature.
作者信息
Muhsen Baha'eddin A, Ghzawi Ansam, Hashem Hasan, Elayyan Maher, Maraqa Bayan, Al Masri Mahmoud
机构信息
Division of Neurosurgery, Department of Surgery, King Hussein Cancer Center, Amman, Jordan.
Faculty of Medicine- Yarmouk University, Irbid, Jordan.
出版信息
Ann Med Surg (Lond). 2021 Apr 15;65:102300. doi: 10.1016/j.amsu.2021.102300. eCollection 2021 May.
INTRODUCTION
and Importance: Adult Pilocytic Astrocytomas (APA) are infrequent low grade tumors. While supratentorial APA is considered rare, insular APA is extremely rare.
CASE PRESENTATION
We present a case of pure insular APA along with surgical outcomes. Tractography and functional MRI were obtained pre-operatively. The patient underwent neuro-navigation guided microsurgical resection with sub-cortical white matter mapping, utilizing Intra-operative MRI guidance. The Sylvain fissure was opened to secure the M3 branches, and near total resection was achieved.
CLINICAL DISCUSSION
APA in the insula is a very rare presentation and is considered challenging. Its proximity to the middle cerebral and lenticulostriate arteries, motor areas, and language areas makes accessing and resecting the tumor challenging. A multidisciplinary approach by an experienced team is needed to plan the management of young adult patients and reach the best outcomes.
CONCLUSION
Implementing microsurgical techniques, modern imaging modalities and intraoperative mapping helps to achieve maximal safe resection without risking functions.
引言
及重要性：成人毛细胞型星形细胞瘤（APA）是罕见的低级别肿瘤。虽然幕上APA被认为罕见，但岛叶APA极为罕见。
病例报告
我们报告一例单纯岛叶APA病例及其手术结果。术前进行了神经纤维束成像和功能磁共振成像。患者在术中磁共振成像引导下，接受了神经导航引导的显微手术切除，并进行了皮质下白质图谱绘制。打开外侧裂以保护M3分支，实现了近全切除。
临床讨论
岛叶APA是一种非常罕见的表现，被认为具有挑战性。它靠近大脑中动脉和豆纹动脉、运动区和语言区，使得肿瘤的暴露和切除具有挑战性。需要经验丰富的团队采用多学科方法来规划年轻成年患者的治疗方案并取得最佳结果。
结论
实施显微外科技术、现代成像方式和术中图谱绘制有助于在不危及功能的情况下实现最大程度的安全切除。
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