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成人神经节细胞胶质瘤

Gangliogliomas in adults.

作者信息

Hakim R, Loeffler J S, Anthony D C, Black P M

机构信息

Department of Neurosurgical Service, Brigham and Women's Hospital, Boston, Massachusetts, USA.

出版信息

Cancer. 1997 Jan 1;79(1):127-31.

PMID:8988736
Abstract

BACKGROUND

Gangliogliomas are rare tumors occurring in both children and adults that are characterized by the presence of neoplastic cells resembling both neurons and glia.

METHODS

The authors reviewed 18 adults patients with intracranial gangliogliomas treated at the study institutions between October 1987 and November 1995.

RESULTS

The median age at diagnosis was 33.7 years, with a range of 21 to 55 years. Median follow-up was 37.7 months, with a range of 4 months to 13 years. Clinical manifestations among the patients included seizures (13), headache (2), ataxia (1), and hemiparesis and paresthesias (1 patient each). Tumors were located in the temporal lobe (6 patients), temporal lobe and thalamus (1 patient), frontal lobe (5 patients), cerebellum (4 patients), and insula or thalamus (1 patient each). Thirteen patients underwent gross total resection, 4 underwent incomplete resection, and 1 underwent only a stereotactic biopsy. Treatment modalities included surgery only, surgery plus radiation, and surgery plus radiation and chemotherapy. Median survival was 90.3 months, with a range of 14 months to 13 years. Three patients were dead at follow-up with a mean survival of 32.3 months. These patients showed anaplastic features in their pathology at initial surgery or surgery for recurrence.

CONCLUSIONS

In adults, gangliogliomas have a relatively favorable prognosis; however, the presence of anaplastic features predicts a worse outcome.

摘要

背景

神经节胶质瘤是一种罕见肿瘤,可发生于儿童和成人,其特征是存在类似神经元和神经胶质细胞的肿瘤细胞。

方法

作者回顾了1987年10月至1995年11月期间在研究机构接受治疗的18例颅内神经节胶质瘤成年患者。

结果

诊断时的中位年龄为33.7岁,范围为21至55岁。中位随访时间为37.7个月,范围为4个月至13年。患者的临床表现包括癫痫发作(13例)、头痛(2例)、共济失调(1例)以及偏瘫和感觉异常(各1例)。肿瘤位于颞叶(6例患者)、颞叶和丘脑(1例患者)、额叶(5例患者)、小脑(4例患者)以及岛叶或丘脑(各1例患者)。13例患者接受了全切除,4例接受了部分切除,1例仅接受了立体定向活检。治疗方式包括单纯手术、手术加放疗以及手术加放疗和化疗。中位生存期为90.3个月,范围为14个月至13年。3例患者在随访时死亡,平均生存期为32.3个月。这些患者在初次手术或复发手术的病理检查中显示有间变特征。

结论

在成人中,神经节胶质瘤预后相对良好;然而,存在间变特征预示着预后较差。

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