Brachium Pontis Gliosarcoma With Well-Differentiated Cartilaginous Tissue: A Case Report.
Brachium Pontis Gliosarcoma With Well-Differentiated Cartilaginous Tissue: A Case Report.
复制标题
具有分化良好软骨组织的臂桥桥胶质肉瘤：病例报告。
DOI：
10.1097/md.0000000000001735
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发表时间：
2015-10
期刊：
影响因子：
1.6
通讯作者：
Peng Z
中科院分区：
文献类型：
--
作者：
Wang L;Xie Y;Liu Y;Tan J;Chen Z;Xiao Y;Xia Y;Peng Z
胶质肉瘤（GS）属于世界卫生组织IV级肿瘤，表现为胶质和间质分化。仅在桥臂和第四脑室区域报道了罕见的GS病例。在此，我们报告一例罕见的位于桥臂区并延伸至第四脑室的GS，并伴有分化良好的软骨化生。28岁男性患者间歇性头痛、呕吐、步态障碍3个月。磁共振成像（MRI）显示左桥臂和第四脑室区呈非均匀环形强化，伴弱中枢强化。组织学显示，GS由胶质细胞和肉瘤组成。经免疫组化分析，诊断为GS伴软骨分化。GS的症状包括头痛、失语、偏瘫、认知能力下降和癫痫发作，主要由部位决定。临床表现及影像学特征与胶质母细胞瘤无明显差异。切除程度是影响GS预后的重要因素，辅助放化疗的临床效果有待进一步研究。报告更多的病例将有助于更好地了解GS的位置和病理类型。
Gliosarcoma (GS) belongs to World Health Organization grade IV neoplasm and displaying glial and mesenchymal differentiation. Only rare cases of GS have been reported in the brachium pontis and 4th ventricle region. Here, we report a rare case of GS located on brachium pontis region and extending into the 4th ventricle with well-differentiated cartilaginous metaplasia. A 28-year-old male patient experienced intermittent headache, vomiting, and gait disorders for 3 months. Magnetic resonance imaging (MRI) showed a heterogeneous ring-enhancement lesion with weak central enhancement in left brachium pontis and 4th ventricle region. Histology revealed the GS was constituted with glial and sarcomatous elements. After immunohistochemical analysis, a diagnosis of GS with cartilaginous differentiation was then made. Symptoms of GS, including headache, aphasia, hemiparesis, cognitive decline, and seizures, mainly determined by the location. The clinical manifestation and radiologic characteristic is not significantly different from that of glioblastoma. The grade of resection is the significant factor related to prognosis of GS, and the clinical effect of adjuvant radiotherapy and chemotherapy need further study. Reporting additional cases would be of great help in better understanding of this location and pathologic type of GS.