Taratuto A L, Pomata H, Sevlever G, Gallo G, Monges J
Instituto de Investigaciones Neurológicas Raúl Carrea, Fundacion para la Lucha contra las Enfermedades Neurológicas de la Infancia, Buenos Aires, Argentina.
Neurosurgery. 1995 Mar;36(3):474-81. doi: 10.1227/00006123-199503000-00005.
Overtreatment by radiotherapy and/or chemotherapy for central nervous system tumors in infancy and childhood may be deleterious, so the recognition of surgically curable clinicopathological entities is mandatory. The dysembryoplastic neuroepithelial tumor is a complex multinodular lesion consisting of glial nodules, associated with a specific glioneuronal element and/or with focal cortical dysplasia, and occurring in young patients presenting with intractable, mostly complex partial, seizures without neurological deterioration. We report on 14 patients; 9 were from a series of 600 pediatric patients with intracranial central nervous system tumors studied at a single institution from 1988 to 1993, and 5 were referred from other pediatric hospitals. Six tumors were frontal, six were temporal, one was parietal, and one was occipitoparietal. Computed tomographic scans disclosed hypodense lesions with cystic appearances in 4 patients and slight focal postcontrast enhancements in only 2 patients, whereas magnetic resonance imaging, available for 7 of 14 patients, showed hypointense lesions in T1-weighted images and hyperintense lesions in T2-weighted images. Deformities of the overlying cranium were also observed in five patients. The age range at the time of surgery (excluding a 20-year-old male patient who underwent surgery at the main pediatric hospital) was 2.6 to 13 years, with a mean of 6.68 years. The male to female patient ratio was 10:4, and the duration of symptoms was 0.2 to 6 years.(ABSTRACT TRUNCATED AT 250 WORDS)
婴儿期和儿童期中枢神经系统肿瘤进行放疗和/或化疗的过度治疗可能有害,因此识别可通过手术治愈的临床病理实体至关重要。胚胎发育不良性神经上皮肿瘤是一种复杂的多结节性病变,由胶质结节组成,与特定的神经胶质神经元成分和/或局灶性皮质发育异常相关,发生于患有难治性、大多为复杂部分性癫痫且无神经功能恶化的年轻患者。我们报告了14例患者;9例来自1988年至1993年在单一机构研究的600例小儿颅内中枢神经系统肿瘤系列,5例由其他儿童医院转诊。6例肿瘤位于额叶,6例位于颞叶,1例位于顶叶,1例位于枕顶叶。计算机断层扫描显示4例患者有低密度囊性病变,仅2例患者有轻微局灶性增强,而14例患者中有7例可进行磁共振成像,显示T1加权图像为低信号病变,T2加权图像为高信号病变。5例患者还观察到颅骨覆盖层畸形。手术时的年龄范围(不包括在主要儿童医院接受手术的一名20岁男性患者)为2.6至13岁,平均为6.68岁。男女患者比例为10:4,症状持续时间为0.2至6年。(摘要截断于250字)