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理解弥漫性软脑膜神经胶质神经元肿瘤。

Understanding diffuse leptomeningeal glioneuronal tumors.

机构信息

Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, ONT, Canada.

Department of Pathology, The Hospital for Sick Children, Toronto, ONT, Canada.

出版信息

Childs Nerv Syst. 2024 Aug;40(8):2359-2366. doi: 10.1007/s00381-024-06432-6. Epub 2024 May 25.

Abstract

INTODUCTION

Diffuse leptomeningeal glioneuronal tumors (DLGNTs) pose a rare and challenging entity within pediatric central nervous system neoplasms. Despite their rarity, DLGNTs exhibit complex clinical presentations and unique molecular characteristics, necessitating a deeper understanding of their diagnostic and therapeutic nuances.

METHODS

This review synthesizes contemporary literature on DLGNT, encompassing epidemiology, clinical manifestations, pathological features, treatment strategies, prognostic markers, and future research directions. To compile the existing body of knowledge on DLGNT, a comprehensive search of relevant databases was conducted.

RESULTS

DLGNT primarily affects pediatric populations but can manifest across all age groups. Its diagnosis is confounded by nonspecific clinical presentations and overlapping radiological features with other CNS neoplasms. Magnetic resonance imaging (MRI) serves as a cornerstone for DLGNT diagnosis, revealing characteristic leptomeningeal enhancement and intraparenchymal involvement. Histologically, DLGNT presents with low to moderate cellularity and exhibits molecular alterations in the MAPK/ERK signalling pathway. Optimal management of DLGNT necessitates a multidisciplinary approach encompassing surgical resection, chemotherapy, radiotherapy, and emerging targeted therapies directed against specific genetic alterations. Prognostication remains challenging, with factors such as age at diagnosis, histological subtypes, and genetic alterations influencing disease progression and treatment response. Long-term survival data are limited, underscoring the need for collaborative research efforts.

CONCLUSION

Advancements in molecular profiling, targeted therapies, and international collaborations hold promise for improving DLGNT outcomes. Harnessing the collective expertise of clinicians, researchers, and patient advocates, can advance the field of DLGNT research and optimize patient care paradigms.

摘要

简介

弥漫性软脑膜胶质神经元肿瘤(DLGNTs)是儿童中枢神经系统肿瘤中一种罕见且具有挑战性的实体。尽管它们较为罕见,但 DLGNTs 表现出复杂的临床表现和独特的分子特征,因此需要更深入地了解其诊断和治疗的细微差别。

方法

本综述综合了 DLGNT 的当代文献,包括流行病学、临床表现、病理学特征、治疗策略、预后标志物和未来的研究方向。为了汇编关于 DLGNT 的现有知识体系,我们对相关数据库进行了全面搜索。

结果

DLGNT 主要影响儿童人群,但也可发生于所有年龄段。其诊断受到非特异性临床表现和与其他 CNS 肿瘤重叠的影像学特征的影响。磁共振成像(MRI)是 DLGNT 诊断的基石,可显示特征性软脑膜增强和脑实质受累。组织学上,DLGNT 表现为低到中度细胞密度,并存在 MAPK/ERK 信号通路的分子改变。DLGNT 的最佳治疗需要多学科方法,包括手术切除、化疗、放疗和新兴的针对特定遗传改变的靶向治疗。预后仍然具有挑战性,诊断时的年龄、组织学亚型和遗传改变等因素会影响疾病进展和治疗反应。长期生存数据有限,突显了合作研究的必要性。

结论

在分子谱分析、靶向治疗和国际合作方面的进展有望改善 DLGNT 的结局。汇集临床医生、研究人员和患者倡导者的集体专业知识,可以推动 DLGNT 研究领域的发展并优化患者护理模式。

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