脊髓神经节胶质细胞瘤三例并文献复习

Spinal ganglioglioma： report of three cases and review of literature

目的探讨脊髓神经节胶质细胞瘤的临床特点和手术治疗。方法收集北京天坛医院神经外科自2010年10月至2011年3月的3例脊髓神经节胶质细胞瘤手术患者资料，结合文献复习进行临床分析。结果3例患者均以肢体感觉或运动功能障碍起病；MRI检查具低T1高T2信号特征，强化多样，瘤周水肿明显，需与星形细胞瘤、室管膜瘤等其他类型神经上皮来源肿瘤相鉴别；患者行肿瘤全切除或近全切除术，术中肿瘤边界分辨困难；手术病理诊断为神经节胶质细胞瘤、WHOI级，病理切片上混合表达肿瘤性神经节细胞及神经胶质细胞；术后临床症状缓解明显，未行放疗等其他辅助治疗。结论脊髓神经节胶质细胞瘤相对少见，致残率高，术前诊断困难，手术切除难度大；如手术切除满意预后良好，不需常规行放疗等辅助治疗。

Objective To investigate the clinical characteristics and surgery treatment of spinal ganglioglioma. Methods We report 3 cases of spinal ganglioglioma of our neurosurgical department from Oct. 2010 to Mar. 2011, with review of literature. Results All 3 patients admitted for sensory or motor dysfunctions. The preoperative MR showed T1 - weighted hypointense T2 - weighted hyperintense signal, with heterogeneous enhancement and peritumoral edema, which resembled other tumors of the neuroepithelial tissue of the CNS like astrocytoma, ependymoma. The gross total or subtotal tumor resections were performed for each patient. The tumor had no clear boundary, and the intraoperative distinguishment was difficult. The pathology examination suggested both neoplastic mature ganglion and neoplastic glial cells. The patients recovered well after the operation, with no further adjuvant therapy. Conclusions Spinal ganglioglioma has a low incidence, although more handicapped. Preoperative diagnosis proves to be a challenge, and given the blurred margin more skill and experience are required during the operation. However, a satisfactory surgery alone promise a good prognosis.