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出血性成星形细胞瘤:一种罕见肿瘤的非典型表现。病例说明。

Hemorrhagic astroblastoma: atypical presentation of a rare tumor. Illustrative case.

作者信息

Zumaeta Jorge, Martinez Raul, Santiago Rea Noe, Anicama-Lima William Efrain, Casavilca-Zambrano Sandro, Valerio Jose

机构信息

Neurosurgical Oncology Department, Latinoamerica Valerio Foundation, Weston, Florida.

Vascular, Tumors and Functional Neurosurgery Service, Neurosurgery Department, Guillermo Almenara Irigoyen National Hospital, La Victoria, Lima, Peru.

出版信息

J Neurosurg Case Lessons. 2025 Jan 20;9(3). doi: 10.3171/CASE24486.

Abstract

BACKGROUND

Astroblastoma is an extremely rare tumor of the central nervous system, and its origin and validity as a different entity are still being debated. Because of its rarity and similarities to other glial neoplasms, it is often misdiagnosed, impacting treatment and outcomes.

OBSERVATIONS

Astroblastoma is very rare and mainly affects children and young adults. It does not have a definitive World Health Organization grade and is divided into low- and high-grade categories. The clinical presentation is consistent with signs of intracranial hypertension. Radiographic imaging shows a bubbly, solid-cystic supratentorial mass with irregular contrast enhancement. The case reported herein is unusual because the intratumoral hemorrhage caused compression and midline shift, requiring urgent surgery.

LESSONS

Astroblastoma with intratumoral hemorrhage is atypical and is associated with high-grade tumors. Managing severe intracranial hypertension requires emergency surgery to prevent fatalities. Treatment can include adjunctive chemotherapy and radiation therapy based on the extent of tumor resection. https://thejns.org/doi/10.3171/CASE24486.

摘要

背景

成星形细胞瘤是一种极其罕见的中枢神经系统肿瘤,其起源以及作为一种独立实体的有效性仍存在争议。由于其罕见性以及与其他胶质肿瘤的相似性,它常被误诊,从而影响治疗和预后。

观察结果

成星形细胞瘤非常罕见,主要影响儿童和年轻人。它没有明确的世界卫生组织分级,分为低级别和高级别两类。临床表现与颅内高压症状相符。影像学检查显示幕上有一个呈泡沫状、实性-囊性的肿块,对比增强不规则。本文报道的病例不寻常,因为肿瘤内出血导致了压迫和中线移位,需要紧急手术。

经验教训

伴有肿瘤内出血的成星形细胞瘤不典型,与高级别肿瘤相关。处理严重的颅内高压需要紧急手术以防止死亡。治疗可包括根据肿瘤切除范围进行辅助化疗和放疗。https://thejns.org/doi/10.3171/CASE24486

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0546/11744686/a6019140028d/CASE24486_figure_1.jpg

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