Volpentesta Giorgio, Donato Giuseppe, Ferraro Elisabetta, Mignogna Chiara, Radaelli Riccardo, Sabatini Umberto, La Torre Domenico, Malara Natalia
Department of Medical and Surgical Sciences, University "Magna Græcia", Catanzaro, Italy.
Department of Health Sciences, University Magna Græcia, Catanzaro, Italy.
Front Oncol. 2021 Oct 27;11:737730. doi: 10.3389/fonc.2021.737730. eCollection 2021.
Imaging limitations, invasive tissue biopsies and poor information over the course of treatment to evaluate 'real-time' tumor dynamics justify the emerging use of liquid biopsies in the field of brain tumors. Circulating tumor cells (CTCs) from high-grade astrocytomas might reach the circulation by crossing the blood-brain barrier. Here, for the first time, CTCs cytology in a case of pylocitic astrocytoma is described. An obstructive hydrocephalous due to a lateral mesencephalic tectum mass occluding the Silvio Aqueduct was diagnosed in a young, 18 years old, male. Considering the location of the tumor and the rapid deterioration of the neurological status, it has been decided to urgency treat the patient with ventriculoperitoneal shunting. Magnetic resonance imaging showed a nodular shaped lesion localized within the left lateral mesencephalic tectum. Stereotactic biopsy was not approachable due significant risk of neurological consequences. The diagnosis was performed by blood sampling, a non-invasive procedure for the patient, in order to provide tumor information. Cytopathological features on detected circulating atypical GFAP positive cells led to pilocytic diagnosis confirmed by the patient's 68 months outcome.
成像的局限性、侵入性组织活检以及在治疗过程中用于评估“实时”肿瘤动态的信息不足，使得液体活检在脑肿瘤领域的应用日益广泛。高级别星形细胞瘤的循环肿瘤细胞（CTC）可能通过穿越血脑屏障进入血液循环。在此，首次描述了一例毛细胞型星形细胞瘤患者的CTC细胞学情况。一名18岁男性被诊断出因中脑外侧顶盖肿块阻塞中脑导水管而导致梗阻性脑积水。考虑到肿瘤的位置以及神经功能状态的迅速恶化，决定紧急对患者进行脑室腹腔分流术治疗。磁共振成像显示左侧中脑外侧顶盖有一个结节状病变。由于存在严重的神经后果风险，无法进行立体定向活检。通过对患者进行血液采样这一非侵入性操作来进行诊断，以获取肿瘤信息。检测到的循环非典型GFAP阳性细胞的细胞病理学特征导致了毛细胞型诊断，患者68个月的预后证实了这一诊断。
