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本文报道了小儿神经母细胞瘤14例,尸解发现3例;5例颅脑转移发生在腹部原发病灶大部切除术后辅以化疗期间;6例辅助检查确诊神经母细胞瘤,其中3例拟延期手术,先行化疗尚未达到GPR标准出现颅脑转移,另3例原发病灶小,部位隐匿未被发现,而以颅脑转移为首发症状就诊。颅脑转移的诊断有赖于影像学检查,除硬脑膜外、脑实质转移外,位于后腹膜脊柱旁的神经母细胞瘤经椎间孔浸润到椎管内经脑脊液逆行扩散引起中枢神经系统广泛转移尚未引起重视。硬脑膜外、脑实质的转移可行外科手术,中枢神经系统广泛转移可采用放射治疗并均辅以较强烈化疗。
This paper reports 14 cases of pediatric neuroblastoma, autopsy found in 3 cases; 5 cases of brain metastases occurred in the abdomen after the primary lesion subtotal adjuvant chemotherapy; 6 cases of neuroblastoma assisted examination, of which 3 Cases to be postponed surgery, chemotherapy has not yet reached the GPR standard craniocerebral metastasis, and the other three cases of primary lesion, hidden parts were not found, and the first symptom of brain metastasis for treatment. The diagnosis of brain metastasis depends on the imaging examination, in addition to dura, brain parenchymal metastasis, located in the retroperitoneal paravertebral neuroblastoma by intervertebral foramen infiltration into the spinal canal retrograde diffusion of cerebrospinal fluid caused by extensive metastasis of the central nervous system has not yet Caused attention. Dural, brain parenchymal metastases may be surgical, extensive metastasis of the central nervous system can be treated with radiotherapy and are supplemented by more intense chemotherapy.