Laboratory of Molecular and Cellular Biology (LIM15), Department of Neurology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Avenida Dr Arnaldo, 455/ 4º Andar/ sala 4110, São Paulo, SP, Cep: 01246-903, Brazil.
Neurosurgery Division, Department of Neurology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, SP, Brazil.
Neurosurg Rev. 2024 Feb 26;47(1):93. doi: 10.1007/s10143-024-02327-x.
To describe the natural history of spinal gangliogliomas (GG) in order to determine the most appropriate neuro-oncological management. A Medline search for relevant publications up to July 2023 using the key phrase "ganglioglioma spinal" and "ganglioglioma posterior fossa" led to the retrieval of 178 studies. This corpus provided the basis for the present review. As an initial selection step, the following inclusion criteria were adopted: (i) series and case reports on spinal GG; (ii) clinical outcomes were reported specifically for GG; (iii) GG was the only pathological diagnosis for the evaluation of the tumor; (iv) papers written only in English was evaluated; and (v) papers describing each case in the series were included. The World Health Organization (WHO) 2021 grading criteria for gangliogliomas were applied. A total of 107 tumors were evaluated (63 from male patients and 44 from female patients; 1.43 male/1.0 female ratio, mean age 18.34 ± 15.84 years). The most common site was the cervical spine, accounting for 43 cases (40.18%); GTR was performed in 35 cases (32.71%) and STR in 71 cases (66.35%), while this information was not reported in 1 case (0.94%). 8 deaths were reported (7.47%) involving 2 males (25%) and 6 females (75%) aged 4-78 years (mean 34.27 ± 18.22) years. GGs located on the spine displayed the same gender ratio as these tumors in general. The most frequent symptom was pain and motor impairment, while the most prevalent location was the cervical spinal cord. GTR of the tumor posed a challenge for neurosurgeons, due to the difficulty of resecting the lesion without damaging the spinal eloquent area, explaining the lower rate of cure for this tumor type.
为了描述脊髓神经节细胞瘤（GG）的自然病史，以确定最合适的神经肿瘤学管理方法。使用关键词“脊髓 GG”和“后颅窝 GG”在 Medline 上进行了截至 2023 年 7 月的相关文献检索，共检索到 178 项研究。该文献库为本次综述提供了依据。作为初步选择步骤，我们采用了以下纳入标准：（i）脊髓 GG 的系列和病例报告；（ii）专门报告了 GG 的临床结果；（iii）GG 是评估肿瘤的唯一病理诊断；（iv）评估仅为英文文献；（v）纳入了系列中描述每个病例的论文。采用世界卫生组织（WHO）2021 年神经节细胞瘤分级标准。共评估了 107 个肿瘤（男性患者 63 例，女性患者 44 例；男/女比例为 1.43:1.0，平均年龄为 18.34±15.84 岁）。最常见的部位是颈椎，占 43 例（40.18%）；35 例（32.71%）行肿瘤全切除（GTR），71 例（66.35%）行次全切除（STR），而 1 例（0.94%）未报告。报道了 8 例死亡（7.47%），涉及 2 例男性（25%）和 6 例女性（75%），年龄为 4-78 岁（平均 34.27±18.22 岁）。位于脊柱的 GG 与一般 GG 具有相同的性别比。最常见的症状是疼痛和运动障碍，最常见的部位是颈脊髓。由于难以在不损伤脊髓功能区的情况下切除病变，因此对于神经外科医生来说，肿瘤的 GTR 具有挑战性，这也解释了这种肿瘤类型的治愈率较低。
