颅内多中心少突星形细胞瘤1例报告及文献复习

Intracranial multicentric astrocytoma:A case report and literature review

目的:报道1例颅内多中心少突星形细胞瘤病例的临床表现,为其临床诊断和治疗提供参考。方法:回顾性分析1例颅内多中心少突星形细胞瘤患者的临床资料,将诊治经过进行总结,并进行相关文献复习。结果:患者为男性,25岁,因"18d前突发抽搐1次"入院。头部MRI平扫加增强,左侧额叶、胼胝体膝部见团片状混杂异常信号,左侧额颞叶见囊片状混杂信号影。行手术治疗,于一次手术中先后切除左侧额叶、胼胝体膝部及左侧额颞叶病变,术中见2处病变性质有所区别(左侧额叶和胼胝体膝部病变为囊性及实性混合组织,实性组织占大部分,内部可见钙化;左侧额颞叶病变为囊性及实性混合组织,囊性组织占大部分);术后病理回报左侧额叶和胼胝体病变局部细胞密度增高,细胞异型相对明显,诊断为少突星形细胞瘤(WHOⅡ-Ⅲ级),左侧额颞叶病变诊断为少突星形细胞瘤(WHOⅡ级)。术后患者恢复良好,建议继续行放疗和化疗。结论:对于颅内多中心少突星形细胞瘤患者,积极手术治疗对延长患者的生存期有利,术后是否进行放疗仍存在争议,但化疗应该被推荐。

Objective:To report the clinical manifestations of 1 case of intracranial multicentric astrocytoma,and to provide a reference for its clinical diagnosis and treatment.Methods:The clinical data of one patient with intracranial multicentric astrocytomas were retrospectively analyzed and the diagnosis and treatment were summarized,and the relevant literatures were reviewed.Results:The patient was male,25 years old,and admitted to hospital due to the sudden convulsions 1 time 18 d ago.The head MRI scanning and enhanced scanning displayed that the left frontal lobe and corpus callosum knee exited the group of patchy mixed abnormal signals,and the left frontal temporal lobe exited the capsule-like mixed signals.Surgical treatment was performed,and the lesions of the left frontal lobe and corpus callosum knee and left frontal temporal lobe were resected.The difference of the two lesions was observed during the operation(the left frontal and corpus callosum knee lesion was cystic and solid mixed tissue,solid organization accounted for majority,and had internal calcification;the left frontal temporal lobe lesion was cystic and solid mixed tissue,and cystic tissue accounted for the majority).The postoperative pathology showed that the left frontal lobe and corpus callosum knee lesion had locally more intensive cells,and more different cells,and it was diagnosed as astrocytoma(WHOⅡ-Ⅲ);the left frontal temporal lobe lesion was diagnosed as astrocytoma(WHOⅡ).After operation,the patient recovered well,and it was recommended to continue radiotherapy and chemotherapy.Conclusion:For the patients with intracranial multicentric astrocytomas,active surgical treatment is in favor of prolonging the survival of the patients.Postoperative radiotherapy is still controversial,but chemotherapy should be recommended.