Peritoneal dissemination from central neurocytoma: case report.
Peritoneal dissemination from central neurocytoma: case report.
复制标题
中枢神经细胞瘤腹膜播散：病例报告。
DOI：
10.1590/s0004-282x2003000600028
复制
发表时间：
2003
影响因子：
1.4
通讯作者：
J. Milano
中科院分区：
文献类型：
--
作者：
M. Coelho Neto;R. Ramina;Murilo Sousa DE Meneses;W. Arruda;J. Milano
目的
中枢神经细胞瘤是一种起源于神经胶质的低度恶性肿瘤，是一种较新的组织学实体。只有少数病例报道，其生物学行为仍不确定。一些病例表现出侵袭性行为（局部复发、恶性去分化或CSF播散），并挑战了其相对良性的最初观点。一个中央神经细胞瘤腹膜传播的情况下提出。
情况
一位六岁男童因第三脑室及左侧丘脑的神经细胞瘤复发，在病灶次全切除后三年半，肿瘤静止及腹水快速生长。在腹水中鉴定肿瘤细胞并植入腹膜中。诊断腹膜播散后立即开始化疗（依托泊苷、卡铂、多柔比星和环磷酰胺）。由于腹水的快速形成，患者出现代谢失衡和呼吸衰竭，并在诊断为腹膜播散后3天死亡。
结论
中枢神经细胞瘤是一种低度恶性肿瘤，在大多数病例中增殖指数较低。尽管如此，一些肿瘤可能呈现出非常侵袭性的行为和神经播散。增殖指数的评估可能是一个指导参数，计划在选定的情况下手术治疗后的辅助治疗。在某些情况下可能会发生神经外传播，特别是在脑室腹腔分流术的患者中。
OBJECTIVE
Central neurocytoma is a low grade tumor of neuroglial origin and a relatively new histological entity. Only a few cases have been reported and its biological behavior is still uncertain. Some cases have shown an aggressive behavior (local recurrence, malignant dedifferentiation or CSF dissemination) and challenged the initial view of its relative benignity. A case of central neurocytoma with peritoneal dissemination is presented.
CASE
A six years-old boy with recurrent neurocytoma of III ventricle and left thalamus showed fast growth of tumor rest and ascites three and a half years after subtotal removal of the lesion. Tumor cells were identified in the ascitic fluid and implanted in the peritoneum. Chemotherapy was initiated immediately after diagnosis of peritoneal dissemination (etoposide, carboplatin, doxorubicin and cyclophosphamide). The patient developed metabolic imbalance and respiratory failure due to rapid formation of ascitic fluid and died 3 days after the diagnosis of peritoneal dissemination was established.
CONCLUSION
Central neurocytoma is a low grade tumor with low values of the proliferative index in the majority of cases. In spite of that, some tumors may present a very aggressive behavior and extraneural dissemination. Evaluation of proliferative index may be a guideline parameter for planning adjuvant therapies after surgical treatment in selected cases. Extraneural dissemination may occur in some cases specially in patients with ventriculoperitoneal shunt.