Division of Pediatric Hematology and Oncology, Department of Pediatrics, Ege University School of Medicine, 35030, Bornova, Izmir, Turkey.
Department of Pediatrics, Ege University School of Medicine, Izmir, Turkey.
Childs Nerv Syst. 2022 Sep;38(9):1699-1706. doi: 10.1007/s00381-022-05565-w. Epub 2022 Jun 6.
Dysembryoplastic neuroepithelial tumors (DNETs) are rare, low-grade tumors of the central nervous system (CNS) of childhood. It is an important cause of intractable epilepsy, and it is surgically curable. We aimed to review our institutional experience with DNET in children.
Medical records of children aged less than 18 years of age diagnosed with DNET between 2009 and 2020 at Ege University Hospital were reviewed. Clinical features of the patients including age, gender, initial symptoms, duration of symptoms, medical treatments, age at the time of surgery, tumor location, degree of surgical resection, and outcome of the patients were documented.
We reviewed the records of 17 patients with DNETs. Twelve of them were male (70%), 5 of them female (30%). The median age was 11 years (19 months-17 years). The major symptom was a seizure in all of the patients. Thirteen patients presented with complex partial seizures, whereas 2 had a simple partial seizure, and 2 generalized tonic-clonic seizures. Seven patients had drug resistant epilepsy and had received at least two anti-epileptic drugs before surgery. The median duration of symptoms was 6.6 months (0-48 months). In surgery, total surgical resection was performed in 15 patients, and 2 patients underwent partial resection. From these 15 patients, seven patients underwent lesionectomy of the tumor while the other eight patients had extended lesionectomy. The mean follow-up time was 107 months (54-144 months), the seizure control was achieved in 14 patients (82.4%) after surgery, but 3 patients experienced tumor recurrence in the follow-up.
In DNETs, the complete total resection of the lesion is generally associated with seizure-free outcomes. In the patients with partial resection and lesionectomy, MRI follow-up is recommended for recurrence.
胚胎发育不良性神经上皮肿瘤(DNET)是儿童中枢神经系统(CNS)的罕见低级别肿瘤。它是一种导致难治性癫痫的重要原因,并且可以通过手术治愈。我们旨在回顾我们机构在儿童 DNET 方面的经验。
回顾 2009 年至 2020 年期间在伊兹密尔大学医院被诊断为 DNET 的年龄小于 18 岁的儿童的病历。记录患者的临床特征,包括年龄、性别、首发症状、症状持续时间、治疗方法、手术时的年龄、肿瘤位置、手术切除程度以及患者的结局。
我们回顾了 17 例 DNET 患者的记录。其中 12 例为男性(70%),5 例为女性(30%)。中位年龄为 11 岁(19 个月至 17 岁)。所有患者的主要症状均为癫痫发作。13 例患者表现为复杂部分性癫痫发作,2 例患者表现为单纯部分性癫痫发作,2 例患者表现为全面强直阵挛性癫痫发作。7 例患者患有耐药性癫痫,在手术前至少接受了两种抗癫痫药物治疗。症状持续时间的中位数为 6.6 个月(0-48 个月)。在手术中,15 例患者进行了完全肿瘤切除术,2 例患者进行了部分切除术。在这 15 例患者中,7 例患者进行了肿瘤的病变切除术,而另外 8 例患者进行了扩展病变切除术。平均随访时间为 107 个月(54-144 个月),手术后 14 例患者(82.4%)癫痫发作得到控制,但在随访中有 3 例患者肿瘤复发。
在 DNET 中,病变的完全总切除通常与无癫痫发作的结局相关。对于部分切除和病变切除术的患者,建议进行 MRI 随访以监测复发。