Peschgens T, Stollbrink-Peschgens C, Mertens R, Völker A, Thron A, Heimann G
Kinderklinik, Medizinischen Fakultät, RWTH Aachen.
Klin Padiatr. 1995 Mar-Apr;207(2):52-8. doi: 10.1055/s-2008-1046511.
Carcinomas of the plexus choroideus (PCC) represent the rare malignant variety of plexus choroideus papillomas and take a particularly unfavourable course. Tumors of the plexus choroideus account for about 2-4% of all primary brain tumors in children and 0.5% of those in adults. The PCC is more frequent in children than in adults; the authors found reports on 72 cases of PCC in children and on 16 cases in adults. In most cases the PCC is located in the lateral ventricles. The symptoms caused by PCC are non specific and appear as those of increased intracranial pressure (on the basis of hydrocephalus hypersecretorius and/or occlusivus). As the nature of the tumor cannot be identified by means of medical imaging, the diagnosis is usually set up histologically. Prognosis is poor for patients treated only by surgery, which in most cases has been performed as subtotal resection of the tumor. So the necessity for an oncological strategy combining surgery and 'adjuvant' therapy arises. The authors report the application of such a strategy in the case of a three-year-old boy with a PCC of the left lateral ventricle. After nearly four years of remission, the boy died of meningeosis carcinomatosa. This course underlines the malignancy of this tumor; even after years the poor prognosis can still be diminished by the spread of meningeal metastases. In a survey of the case reports published in literature the patients' data, their therapy and the outcome are demonstrated.(ABSTRACT TRUNCATED AT 250 WORDS)
脉络丛癌(PCC)是脉络丛乳头状瘤中罕见的恶性类型,病程特别凶险。脉络丛肿瘤约占儿童原发性脑肿瘤的2 - 4%,占成人原发性脑肿瘤的0.5%。PCC在儿童中比在成人中更常见;作者发现有关于72例儿童PCC和16例成人PCC的报道。在大多数情况下,PCC位于侧脑室。PCC引起的症状不具特异性,表现为颅内压升高(基于分泌过多性脑积水和/或梗阻性脑积水)的症状。由于无法通过医学影像识别肿瘤的性质,诊断通常通过组织学确立。仅接受手术治疗的患者预后较差,大多数情况下手术是肿瘤次全切除。因此,需要一种将手术与“辅助”治疗相结合的肿瘤治疗策略。作者报告了在一名患有左侧脑室PCC的三岁男孩中应用这种策略的情况。经过近四年的缓解期后,该男孩死于癌性脑膜炎。这个病程凸显了这种肿瘤的恶性程度;即使数年之后,脑膜转移的扩散仍会使预后不良的情况加剧。在对文献中发表的病例报告进行的一项调查中,展示了患者的数据、治疗方法及结果。(摘要截选至250字)