Jellinger K, Schuster H
Zentralbl Allg Pathol. 1977;121(6):526-34.
8 cases are reported of anaplastic cerebral gliomas with metastases outside the neuraxis, which were seen among about 1600 gliomas. The series included 4 males and 4 females ranging in age from 5 to 58 years at the time of death. There were 2 children with anaplastic ependymomas, one adult with oligodendroglioma, and 5 young or middle-aged adults with astrocytomas grade III or IV. All patients had one or more craniotomies, and 5 had radiotherapy before the appearance of remote tumor deposits. The survival times ranged from 7 to 31 months in cases with gliomas grade II, and from 8 to 18 months in high-grade astrocytomas. All tumors showed invasion of the meninges and/or ventricle walls, and in 4 cases they transgressed the dura and surrounding bone or soft tissues. In 6 autopsy cases there was widespread dissemination of gliomas through the CSF pathways. Remote metastases involved regional or distant lymph nodes in 7, the lungs in 2, the vertebrae, lungs, pleura, parotis and mediastinum in one patient each. The possible pathways for distant spread of intracranial gliomas and the factors which are considered responsible for their rare occurrence are discussed.
报告了8例间变性脑胶质瘤发生神经轴外转移的病例,这些病例见于约1600例胶质瘤中。该系列包括4名男性和4名女性,死亡时年龄在5至58岁之间。其中有2例儿童间变性室管膜瘤,1例成人少突胶质细胞瘤,5例青年或中年成人III级或IV级星形细胞瘤。所有患者均接受过一次或多次开颅手术,5例在远处肿瘤转移灶出现前接受过放疗。II级胶质瘤患者的生存时间为7至31个月,高级别星形细胞瘤患者的生存时间为8至18个月。所有肿瘤均显示侵犯脑膜和/或脑室壁,4例肿瘤突破硬脑膜及周围骨质或软组织。6例尸检病例中,胶质瘤通过脑脊液途径广泛播散。远处转移累及区域或远处淋巴结7例,肺2例,1例患者转移至椎骨、肺、胸膜、腮腺和纵隔。讨论了颅内胶质瘤远处转移的可能途径以及导致其罕见发生的因素。