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分析儿童颅咽管瘤颅外复发的不同途径:病例报告与文献复习。

Analysis of the different pathways of ectopic recurrence of craniopharyngioma in pediatric patients: presentation of cases and review of the literature.

机构信息

Department of Neurosurgery, Hospital de Pediatría J.P. Garrahan, Buenos Aires, Argentina.

Department of Neurosurgery, Hospital Eva Perón, Buenos Aires, Argentina.

出版信息

Childs Nerv Syst. 2024 Nov;40(11):3511-3518. doi: 10.1007/s00381-024-06585-4. Epub 2024 Aug 26.

Abstract

PURPOSE

Craniopharyngioma is a tumor derived from the squamous epithelium of Rathke's pouch. Despite successful excision, recurrence is common, typically occurring at the original tumor site. More rarely, recurrences can manifest at distant locations. This article reports on three distinct types of ectopic recurrence and reviews the existing literature.

METHODS

We reviewed clinical records and neuroimaging data of craniopharyngioma patients at our institution, identifying three cases of ectopic recurrence. Additionally, we conducted a literature review of similar cases published between 1975 and 2023, focusing on historical background, pathophysiology, clinical and radiological features, and treatment options.

RESULTS

We identified nineteen articles detailing ectopic recurrence of craniopharyngiomas in pediatric patients. The right frontal lobe was the most frequently reported site of recurrence. The shortest interval to recurrence was 11 months, while the longest was 14 years. Most cases were managed with surgical resection, yielding positive outcomes. In our cases, the recurrence sites were temporal intraparenchymal, intraosseous orbital, and occipital intraventricular. All were successfully treated with surgery, with no subsequent recurrences.

CONCLUSION

Although craniopharyngiomas are histologically benign, they can recur locally and, more rarely, at distant sites. Surgical intervention is generally well-tolerated. Further research into tumor cell dissemination mechanisms is essential to develop strategies for preventing ectopic recurrence.

摘要

目的

颅咽管瘤是一种来源于 Rathke 囊的鳞状上皮的肿瘤。尽管成功切除,但复发很常见,通常发生在原肿瘤部位。更罕见的是,复发可出现在远处部位。本文报告了三种不同类型的异位复发,并复习了现有文献。

方法

我们回顾了我们机构的颅咽管瘤患者的临床记录和神经影像学数据,确定了 3 例异位复发病例。此外,我们对 1975 年至 2023 年期间发表的类似病例的文献进行了综述,重点关注历史背景、病理生理学、临床和影像学特征以及治疗选择。

结果

我们确定了 19 篇详细描述儿童患者颅咽管瘤异位复发的文章。复发最常发生于右侧额叶。复发的最短间隔为 11 个月,最长为 14 年。大多数病例采用手术切除治疗,取得了良好的效果。在我们的病例中,复发部位分别为颞叶脑内、眶内骨、枕叶脑室内。所有病例均通过手术成功治疗,无后续复发。

结论

尽管颅咽管瘤在组织学上是良性的,但它们可能会在局部和更罕见的远处部位复发。手术干预通常耐受性良好。进一步研究肿瘤细胞播散机制对于制定预防异位复发的策略至关重要。

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