Di Rocco C, Ceddia A, Iannelli A
Institute of Neurosurgery, Catholic University Medical School, Rome, Italy.
Acta Neurochir (Wien). 1993;123(1-2):14-24. doi: 10.1007/BF01476280.
The authors report on 51 infants with intracranial tumours treated in an eleven-year period; these infants represent 13% of the total population of children with intracranial tumours who have been operated on in the same institution during the same period of time. Males (28 cases) were slightly more frequent. Astrocytomas (17 cases), medulloblastomas (12 cases), and ependymal tumours (5 cases) were the commonest histologic types. Signs and symptoms of increased intracranial pressure were by far the most frequent clinical manifestations, followed by seizure disorders. Thirty tumours were localized within the supratentorial, and 21 within the subtentorial compartment. The parasellar region (10 cases) and the lateral cerebral ventricles (8 cases) for the supratentorial tumours, the inferior cerebellar vermis and fourth ventricle (13 cases) for the infratentorial tumours appeared to be the preferred topographic locations. Craniotomies were carried out in 44 infants, with a total or radical removal of the tumour in 19 cases, a subtotal removal in 6 cases, and a partial removal in 17 cases. In 3 cases only a biopsy procedure was performed. Twenty-nine of these patients required an ancillary procedure such as CSF shunting. Three subjects underwent a biopsy procedure and 1 infant the insertion of a CSF shunting device only. Surgery was not performed in 5 cases. Overall, there were two surgical deaths. Two infants died before any surgical treatment could be performed. Radiation therapy was administered to 9 patients when they had reached three years of age. Chemotherapy was given to 21 infants, according to various chemotherapeutic protocols. During the postoperative period 20 deaths (39%) were recorded. Two patients were lost to follow-up. From 1 to 10 years after the operation, 29 patients are still alive, 14 of them (28%) with a normal psychomotor development, 10 (20%) with some neurological or mental deficits, and 5 (10%) with severe psychomotor retardation. There was no apparent correlation in this series between late outcomes and the histological type of the tumour.
作者报告了在11年期间接受治疗的51例颅内肿瘤婴儿；这些婴儿占同期在同一机构接受手术的颅内肿瘤儿童总数的13%。男性（28例）略多。星形细胞瘤（17例）、髓母细胞瘤（12例）和室管膜瘤（5例）是最常见的组织学类型。颅内压升高的体征和症状是迄今为止最常见的临床表现，其次是癫痫发作。30个肿瘤位于幕上，21个位于幕下。幕上肿瘤的鞍旁区域（10例）和侧脑室（8例），幕下肿瘤的小脑蚓部下份和第四脑室（13例）似乎是首选的部位。44例婴儿接受了开颅手术，19例肿瘤完全或根治性切除，6例次全切除，17例部分切除。3例仅进行了活检。其中29例患者需要辅助手术，如脑脊液分流。3例患者接受了活检，1例婴儿仅插入了脑脊液分流装置。5例未进行手术。总体而言，有2例手术死亡。2例婴儿在能够进行任何手术治疗之前死亡。9例患者在3岁时接受了放射治疗。根据各种化疗方案，21例婴儿接受了化疗。术后期间记录到20例死亡（39%）。2例患者失访。术后1至10年，29例患者仍然存活，其中14例（28%）精神运动发育正常，10例（20%）有一些神经或精神缺陷，5例（10%）有严重精神运动发育迟缓。在这个系列中，晚期结果与肿瘤的组织学类型之间没有明显的相关性。
