Department of Neurosurgery, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Department of Neurosurgery, National Institute of Neurology and Neurovascular Diseases, 020021 Bucharest, Romania.
Medicina (Kaunas). 2024 Oct 11;60(10):1667. doi: 10.3390/medicina60101667.
This case report delves into the case of a 56-year-old female patient presenting with progressive cephalalgia syndrome, nausea, vomiting, and gait disorders, diagnosed with a high-grade thalamic glioma. Glioma is the most common form of central nervous system (CNS) neoplasm that originates from glial cells. Gliomas are diffusely infiltrative tumors that affect the surrounding brain tissue. Glioblastoma is the most malignant type, while pilocytic astrocytomas are the least malignant brain tumors. In the past, these diffuse gliomas were classified into different subtypes and grades based on histopathologies such as a diffuse astrocytoma, oligodendrogliomas, or mixed gliomas/oligoastrocytomas. Currently, gliomas are classified based on molecular and genetic markers. After the gross total resection, a postoperative brain CT scan was conducted, which confirmed the quasi-complete resection of the tumor. The successful gross total resection of the tumor in this case, coupled with significant neurological improvement postoperatively, illustrates the potential benefits of aggressive surgical management for thalamic gliomas. This report advocates for further research to assess the efficacy of such interventions in malignant cases and to establish standardized treatment protocols, considering the heterogeneity in prognostic outcomes and the advancements in molecular diagnostics that offer deeper insights into glioma oncogenesis and progression.
本病例报告深入探讨了一位 56 岁女性患者的病例，该患者表现为进行性头痛综合征、恶心、呕吐和步态障碍，被诊断为高级别丘脑神经胶质瘤。神经胶质瘤是最常见的中枢神经系统（CNS）肿瘤，起源于神经胶质细胞。神经胶质瘤是弥漫浸润性肿瘤，影响周围脑组织。胶质母细胞瘤是最恶性的类型，而毛细胞星形细胞瘤是最良性的脑肿瘤。过去，这些弥漫性神经胶质瘤根据组织病理学分类为不同的亚型和等级，如弥漫性星形细胞瘤、少突胶质细胞瘤或混合性神经胶质瘤/少突星形细胞瘤。目前，神经胶质瘤根据分子和遗传标志物进行分类。在大体全切除后，进行了术后脑部 CT 扫描，证实了肿瘤的近全切除。本例肿瘤的大体全切除成功，术后神经功能显著改善，说明了对丘脑神经胶质瘤进行积极手术治疗的潜在益处。本报告主张进一步研究，评估此类干预措施在恶性病例中的疗效，并制定标准化治疗方案，考虑到预后结果的异质性以及分子诊断的进展，这些进展为神经胶质瘤的发生和进展提供了更深入的了解。
