松果区域的良性和恶性瘤
Pavan S Upadhyayula1, Justin A Neira1, Michael L Miller2
1Department of Neurological Surgery, Columbia University, New York, USA.
Advances in experimental medicine and biology
|July 15, 2023
概括
松果区域瘤被分为五种类型. 诊断包括神经影像和活检,放射性手术作为生殖瘤的首选治疗方法,以避免手术.
科学领域:
- 神经瘤学神经瘤学
- 神经外科 神经外科
- 遗传学 是一个遗传学.
背景情况:
- 松果区域的瘤包括五大类:良性瘤,质瘤,乳头瘤,松果副瘤和生殖细胞瘤.
- 遗传学研究已经揭示了细菌瘤和松果膜瘤的特定染色体变异,如RUNDC3A,ASAH1,LPL,DROSHA/DICER1和RB1.1.
- 常见的表现症状包括水头 (恶心,吐,乳头) 和帕里诺三位一体 (抬头,收-收缩阴影,光近瞳孔解离).
研究的目的:
- 概述松果区域瘤的分类,诊断和治疗策略.
- 讨论各种手术方法及其对患者结果的影响.
- 突出基因发现和辅助疗法在治疗这些瘤中的作用.
主要方法:
- 诊断依赖于神经成像 (MRI/CT) 和通过活检确认组织.
- 细菌瘤的诊断可以通过血清或脑脊液 (CSF) 标记物,如α-fetoprotein和β-HCG来帮助.
- 治疗包括CSF转移水,活检 (内镜或立体检查),并使用各种方法进行手术切除 (半球间跨,上大脑内,中/侧上大脑内).
主要成果:
- 放射性外科手术是胚芽瘤的首选治疗方法,可能消除了手术的需要.
- 手术方法的选择取决于瘤的特征,包括接近深静脉结构和瘤侧面位置.
- 手术后的并发症,如出血或胀,可能导致阻塞性脑水和快速恶化.
结论:
- 松果区域瘤的有效管理需要多步骤的方法,包括诊断,手术干预和基于病理学的辅助疗法.
- 手术技术和向治疗的进步对于改善结局和预防恶性松果区域瘤复发至关重要.
- 通过仔细选择手术走廊和考虑静脉解剖学来最大限度地降低手术风险,例如静脉梗塞.
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