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激光间质热疗（LITT）消融多发性胶质母细胞瘤：1例罕见病例

Multiple Glioblastomas Ablation by Laser Interstitial Thermal Therapy (LITT): A Rare Case.

作者信息

Bakrbaldawi Ahmed Abdulsalam Ali, Al-Sheikh Umar, Jiang Hongjie, Zhu Junming

机构信息

Neurosurgery, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, CHN.

Clinical Research Center, Neurological Diseases of Zhejiang Province, Hangzhou, CHN.

出版信息

Cureus. 2024 Aug 12;16(8):e66726. doi: 10.7759/cureus.66726. eCollection 2024 Aug.

DOI:10.7759/cureus.66726
PMID:39268310
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11392511/
Abstract

Multiple glioblastomas (GBMs) are aggressive, malignant, and sporadic brain tumors. We present the case of a 58-year-old patient with two GBMs in the right frontal lobe and associated edema. The patient presented with sudden left limb weakness accompanied by abnormal gait for five consecutive days. Magnetic resonance-guided laser interstitial thermal therapy (MRg-LITT), a minimally invasive technique that disperses thermal energy was used to cauterize the deep-seated brain lesions. Following two sessions of MRg-LITT, the patient showed full remission from symptoms. However, the disruption of the blood-brain barrier (BBB) induced vasogenic edema surrounding the necrotic GBMs. Post-operative nine-month MRI images revealed severe vasogenic edema and compression on the ventricles, shifting the midline toward the left side. Therefore the patient underwent an emergency craniectomy and continues to live with close follow-ups. Here, we established that LITT procedures were effective in cauterizing GBMs with no recurrence.

摘要

多发性胶质母细胞瘤（GBM）是侵袭性、恶性的散发性脑肿瘤。我们报告了一例58岁患者，其右额叶有两个GBM并伴有水肿。患者连续五天出现突发左下肢无力并伴有异常步态。磁共振引导激光间质热疗（MRg-LITT）是一种分散热能的微创技术，用于烧灼深部脑病变。经过两次MRg-LITT治疗后，患者症状完全缓解。然而，血脑屏障（BBB）的破坏导致坏死性GBM周围出现血管源性水肿。术后九个月的MRI图像显示严重的血管源性水肿和脑室受压，中线向左移位。因此，患者接受了紧急开颅手术，并在密切随访下继续生活。在此，我们确定LITT手术在烧灼GBM方面有效且无复发。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c78/11392511/b64a6c8f5523/cureus-0016-00000066726-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c78/11392511/9104547db4f1/cureus-0016-00000066726-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c78/11392511/6cbd461262a8/cureus-0016-00000066726-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c78/11392511/cfe5590092cc/cureus-0016-00000066726-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c78/11392511/09a5eee36eda/cureus-0016-00000066726-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c78/11392511/a3984786865c/cureus-0016-00000066726-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c78/11392511/bf1495ff5a98/cureus-0016-00000066726-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c78/11392511/b64a6c8f5523/cureus-0016-00000066726-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c78/11392511/9104547db4f1/cureus-0016-00000066726-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c78/11392511/6cbd461262a8/cureus-0016-00000066726-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c78/11392511/cfe5590092cc/cureus-0016-00000066726-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c78/11392511/09a5eee36eda/cureus-0016-00000066726-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c78/11392511/a3984786865c/cureus-0016-00000066726-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c78/11392511/bf1495ff5a98/cureus-0016-00000066726-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c78/11392511/b64a6c8f5523/cureus-0016-00000066726-i07.jpg

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本文引用的文献

1
An Overview of MR-Guided Laser Interstitial Thermal Therapy (MRg-LITT) in Disrupting the Blood-Brain Barrier: Efficacy and Duration.磁共振引导激光间质热疗（MRg-LITT）破坏血脑屏障的效果和持续时间概述。
J Integr Neurosci. 2024 Jul 11;23(7):130. doi: 10.31083/j.jin2307130.
2
Laser Interstitial Thermotherapy (LITT) in Recurrent Glioblastoma: What Window of Opportunity for This Treatment?激光间质热疗（LITT）治疗复发性脑胶质瘤：这种治疗的机会窗口有多大？
Technol Cancer Res Treat. 2024 Jan-Dec;23:15330338241249026. doi: 10.1177/15330338241249026.
3
Laser Interstitial Thermal Therapy as a Treatment Option for Malignant Peripheral Nerve Sheath Tumor Metastases to the Brain: A Case Report.
激光间质热疗作为恶性外周神经鞘瘤脑转移的一种治疗选择：一例报告
Cureus. 2024 Feb 8;16(2):e53855. doi: 10.7759/cureus.53855. eCollection 2024 Feb.
4
Multifocal glioblastoma-two case reports and literature review.多灶性胶质母细胞瘤——两例病例报告及文献综述
Chin Neurosurg J. 2021 Jan 15;7(1):8. doi: 10.1186/s41016-020-00223-z.
5
LINC00680 and TTN-AS1 Stabilized by EIF4A3 Promoted Malignant Biological Behaviors of Glioblastoma Cells.由EIF4A3稳定的LINC00680和TTN-AS1促进了胶质母细胞瘤细胞的恶性生物学行为。
Mol Ther Nucleic Acids. 2020 Mar 6;19:905-921. doi: 10.1016/j.omtn.2019.10.043. Epub 2019 Nov 16.
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Clinical implications of multiple glioblastomas: An analysis of prognostic factors and survival to distinguish from their single counterparts.多发性胶质母细胞瘤的临床意义：分析预后因素和生存情况，以将其与单发性胶质母细胞瘤区分开来。
J Formos Med Assoc. 2020 Mar;119(3):728-734. doi: 10.1016/j.jfma.2019.08.024. Epub 2019 Sep 10.
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