多发性硬化症患者中的胶质母细胞瘤
Glioblastoma in Patients With Multiple Sclerosis.
作者信息
Berkman Jillian M, Nakhate Vihang, Gonzalez Castro L Nicolas
机构信息
Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA; Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
出版信息
Neurohospitalist. 2022 Oct;12(4):607-616. doi: 10.1177/19418744221106003. Epub 2022 Jun 8.
BACKGROUND
Although rare, the co-occurrence of multiple sclerosis (MS) and glioma poses unique challenges in terms of diagnosis and management for both neurologists and neuro-oncologists.
METHODS
Here we report on a single-center cohort of four patients with a diagnosis of multiple sclerosis who developed gliomas.
RESULTS
Our cohort reflects the epidemiology of glioma in terms of the relative frequency of IDH-wildtype and IDH-mutant cases. The patients in 3 out of the 4 cases presented did not develop their tumors in areas of pre-existing demyelinating lesions.
CONCLUSIONS
We did not find evidence to support the hypothesis that chronic gliosis from demyelinating plaques may serve as a substrate for secondary induction of a glial neoplasm. In our Discussion, we provide recommendations for distinguishing neoplastic from demyelinating lesions, review the evidence for demyelination as a risk factor for gliomagenesis, and highlight important considerations for the concurrent management of glioma and MS.
背景
尽管多发性硬化症（MS）和胶质瘤同时出现的情况较为罕见，但这给神经科医生和神经肿瘤学家在诊断和治疗方面带来了独特的挑战。
方法
在此，我们报告了一个单中心队列，其中有4例被诊断为多发性硬化症的患者发生了胶质瘤。
结果
就异柠檬酸脱氢酶（IDH）野生型和IDH突变型病例的相对频率而言，我们的队列反映了胶质瘤的流行病学情况。4例患者中有3例的肿瘤并非在先前存在脱髓鞘病变的区域发生。
结论
我们没有找到证据支持以下假设，即脱髓鞘斑块引起的慢性胶质增生可能作为继发性诱导胶质肿瘤的基础。在我们的讨论中，我们提供了区分肿瘤性病变和脱髓鞘病变的建议，回顾了脱髓鞘作为胶质瘤发生风险因素的证据，并强调了同时管理胶质瘤和MS的重要注意事项。
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