Neurocytoma-like neoplasm of the thoracic spine in a 15-month-old child presenting with diffuse leptomeningeal dissemination and communicating hydrocephalus - Case report

被引:16
作者
Psarros, TG
Swift, D
Mulne, AF
Burns, DK
机构
[1] Univ Texas, SW Med Ctr, Dept Neurosurg, Dallas, TX 75390 USA
[2] Univ Texas, SW Med Ctr, Dept Pediat Neurooncol, Dallas, TX 75390 USA
[3] Univ Texas, SW Med Ctr, Dept Neuropathol, Dallas, TX 75390 USA
[4] Childrens Med Ctr, Dallas, TX 75235 USA
关键词
neurocytoma; mixed glioneuronal neoplasm; leptomeningeal dissemination; communicating hydrocephalus; pediatric neurosurgery;
D O I
10.3171/ped.2005.103.2.0184
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
This unusual mixed glioneuronal neoplasm of the spine resembling central neurocytoma is only the second reported example of a neoplasm of this type involving the spinal cord and is, seemingly, the first to present with diffuse leptomeningeal dissemination and communicating hydrocephalus. This 15-month-old boy presented with somnolence, bilateral sixth nerve palsy, and lower-extremity weakness and was found to harbor a primary neoplasm within the thoracic spine and associated syrinx, widespread leptomeningeal dissemination, and communicating hydrocephalus. The patient underwent cerebrospinal fluid shunt placement, thoracic laminectomy for tumor debulking and biopsy, chemotherapy, and radiation therapy to the neuraxis. Immunohistochemically, the tumor was marked by evidence of mixed glial (glial fibrillary acidic protein-positive) and neuronal (synaptophysin-positive) differentiation. Mitotic activity was inconspicuous. No areas of vascular proliferation, necrosis, or marked nuclear pleomorphism were noted. Mixed glioneuronal neoplasms are a heterogeneous group of tumors whose biological potential remains incompletely defined. The present case illustrates the reality that some of these neoplasms can be clinically aggressive, despite comparatively bland histological features. The authors' goal is to acquaint neurosurgeons with the expanding spectrum of mixed glioneuronal neoplasms and with the potential of some of these lesions to pursue an aggressive clinical course.
引用
收藏
页码:184 / 190
页数:7
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