多形性黄色瘤型星形细胞瘤的诊治分析:附7例报道并文献复习

目的 探讨多形性黄色瘤型星形细胞瘤（PXA）的临床表现、影像学表现、病理特征、治疗及预后。方法 回顾性分析2011年7月至2019年7月手术治疗的7例PXA的临床资料，并复习相关文献。结果 7例均以癫痫发作起病；7例肿瘤均位于大脑浅表部位，MRI表现呈实性4例，呈囊实性3例；7例均在显微镜下全切，5例术后行适形放疗，2例间变型术后行同步放化疗；术后病理WHOⅡ级5例，Ⅲ级2例。术后随访6个月~8年，存活6例，术后2例复发，其中1例死亡。结论 PXA临床罕见，癫痫发作是最常见的症状，影像学表现具有一定特点，其病理学特征有别于其他星形细胞瘤，治疗上应手术全切，对术后有残余、复发或间变者可给予放、化疗。

Diagnosis and treatment of pleomorphic xanthoastrocytomas and review of literature related to them (report of 7 cases)

Objective To explore the clinical symptoms, image findings, pathological features, treatment and prognosis of pleomorphic xanthoastrocytomas (PXA). Methods The clinical data of 7 patients with PXA, who underwent neurosurgery in our hospital from July, 2011 to July, 2019, were analyzed retrospectively. The literature related to PXA was reviewed. Results The age ranged from 19 to 53 years (mean, 34 years) in 7 patients, in whom epilepsy was the dominant clinical manifestation. MRI showed that of 7 PXA, 4 were solid and 3 solid lesions with cysts. There were WHO grade Ⅱ tumors in 5 patients and WHO grade Ⅲ in 2. All the patients received total resection of PXA. Of 7 patients, 5 received conformal radiotherapy and 2 simultaneous radiotherapy and chemotherapy after the operation. Following -up from 6 months to 8 years showed that of 7 patients, 6 were survival and 1 died. PXA recurred in 2 patients. Conclusions PXA is a rare tumor. Epileptic seizure is its main clinical symptom. There are some imaging characteristics in PXA. The pathologic characteristics of PXA are different from the other astrocytomas. Radiotherapy and chemotherapy should be used in the patients with residual PXA or relapse PXA or canceration of PXA.