Pahapill P A, Ramsay D A, Del Maestro R F
Department of Clinical Neurological Sciences, Victoria Hospital Research Institute, London, Canada.
Neurosurgery. 1996 Apr;38(4):822-8; discussion 828-9.
The case of a patient with a pleomorphic xanthoastrocytoma (PXA), a low-grade glioma of adolescence, is presented. A literature review of 79 patients with PXAs is described and confirms a favorable prognosis in 80% of patients. The sex ratio in the reported cases was almost equal, and the median age at time of diagnosis was 14 years. Seventy-nine percent of the patients presented with seizures. Nine of the 15 deaths from PXA are associated with histological evidence of necrosis at initial presentation or in a recurrent tumor, confirming the poor prognosis associated with the presence of necrosis in these neoplasms. Survival curves confirm that the optimal treatment for PXAs without necrosis is primary surgical resection with subsequent operation for recurrent tumor. The roles of surgery or radiotherapy in necrotic PXA are not clear from the literature.
本文报告了一例多形性黄色星形细胞瘤（PXA）患者，这是一种青少年低度胶质瘤。文中描述了对79例PXA患者的文献回顾，证实80%的患者预后良好。报告病例中的性别比例几乎相等，诊断时的中位年龄为14岁。79%的患者出现癫痫发作。15例死于PXA的患者中有9例与初次就诊或复发肿瘤时的坏死组织学证据相关，证实这些肿瘤中存在坏死与预后不良相关。生存曲线证实，对于无坏死的PXA，最佳治疗方法是初次手术切除，复发肿瘤时进行二次手术。手术或放疗在坏死性PXA中的作用在文献中尚不清楚。
