Kopachev D N, Shishkina L V, Shkatova A M, Golovteev A L, Troitsky A A, Grinenko O A, Sharkova S M, Petrosyan D V, Gushcha A O
Research Center of Neurology, Moscow, Russia.
Burdenko National Medical Research Center for Neurosurgery, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2022;122(4):127-134. doi: 10.17116/jnevro2022122041127.
The goal of this review is to summarize data concerning radiological and histological diagnosis of epileptogenic tumors, as well as to discuss their surgical treatment.
PubMed literature database was searched for relevant articles, we also used our own clinical experience.
Benign glioneuronal tumors are the second most common cause of drug resistant epilepsy in adults after hippocampal sclerosis. Exceptionally slow growth (more than 2 years), localization in the brain cortex, presence of differentiated neuronal tissue in tumoral body and long history of epilepsy are the key features of these tumors called LEAT (long-term epilepsy-associated tumors). Management of LEAT requires epileptological as well as neurooncological approach. The epileptogenic zone commonly spreads beyond the tumor borders and simple lesionectomy alone may not be sufficient for achieving seizure freedom.
LEAT typically exhibit low proliferative activity, however they should be thoroughly differentiated from more aggressive glial tumors; while this task is sometimes quite challenging, it's achievable by means of histological and immunohistochemical examination.
本综述的目的是总结有关致痫性肿瘤的放射学和组织学诊断的数据，并讨论其外科治疗。
在PubMed文献数据库中检索相关文章，我们还运用了自己的临床经验。
良性神经胶质神经元肿瘤是继海马硬化后成人药物难治性癫痫的第二大常见病因。这些称为LEAT（长期癫痫相关肿瘤）的肿瘤的关键特征是生长异常缓慢（超过2年）、位于脑皮质、肿瘤体内存在分化的神经元组织以及癫痫病史较长。LEAT的治疗需要癫痫学和神经肿瘤学方法。致痫区通常超出肿瘤边界，单纯的病变切除术可能不足以实现无癫痫发作。
LEAT通常表现出低增殖活性，然而它们应与侵袭性更强的胶质瘤充分区分；虽然这项任务有时颇具挑战性，但通过组织学和免疫组化检查是可以实现的。
