c****l
发帖数: 25 | 1 果然是pilocytic astrocytoma. 楼主应该不用担心了. 这个case不需要也不能放疗.
国内治疗中枢神经系统肿瘤似乎跟美国40年前差不多. 为了小孩子，有必要多说几句：
1. 除了极个别例子以外，Pilocytic astrocytoma只能是1级（WHO grade 1), 没有"1
到2级"的诊断.
2. 40-50年前美国治疗Pilocytic astrocytoma是手术切除+放疗. 后来发现光采取手术
切除就足够了， 而且当时接受了放疗的小孩发现有更多的后遗症， 包括从良性转化成
恶性肿瘤。 相反，没有接受放疗的小孩几乎从来不会转化成恶性。
3. 目前美国的治疗方法就只是手术，不能放疗. 可能很多年以后Pilocytic
astrocytoma会有复发，但是还会是一样的良性， 1级， 手术再切除就可以了.
4. 不能放疗，不能放疗，不能放疗. 有必要的话到美国随便一家医院做second
opinion. |
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l*h
发帖数: 4124 | 2 did I miss something? if you say 脑胶质母瘤, this means surgery has already
been done. it is diagnosed by pathology. conclusion section of MRI report
should read something like "consistent with HGG in xxx area, GBM likely." or
sometimes "consistent with GBM." depending on how good the radiologist is,
the accuracy can be as high as 95%, it can also be much lower.
in most brain areas, when HGG is suspected, the only biopsy type is open
biopsy, that is, you open up the field, take a few pieces of sample... 阅读全帖 |
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l*h
发帖数: 4124 | 3 every one was surprised. the senior pathologist said it was not the first
but very very rare. pilocytic astro, you'd expect most are in young adults
and children, even though it can occur anywhere, most are in infratentorial
compartment (mainly cerebellum), you'd expect cystic changes, with ring
enhancement on T1 with.
much more often, anaplastic astro/oligo cannot be well differentiated from
gbm on mri.
,
GBM, |
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c****l
发帖数: 1086 | 4 Pilocytic astrocytoma and medulloblastoma are the most common cerebellar
tumors in children. The have very different prognosis. In terms of pediatric
cancer
particularly brain tumor, st jude children's research hospital is the best
in the US and the world. Plus, the hospital does not charge the patients a
penny out of their own pockets. |
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c****l
发帖数: 25 | 5 The MRI shows a cerebellar cystic mass with a large mural nodule associated
with hydrocephalus, most likely representing a pilocytic astrocytoma, a
benign tumor with an excellent prognosis. If the diagnosis is confirmed by a
biopsy, then surgery myself would be curative. Any radiation therapy will
be contraindicated because of the risk of malignant transformation in the
future. |
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s**r
发帖数: 685 | 6 如果是 Pilocytic astrocytoma，prognosis会很乐观。Best of luck!
pediatric |
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a*********8
发帖数: 296 | 7 板上大牛太厉害了，最后结果怎么样，希望楼主来更新一下，bless，希望是pilocytic
astrycytoma. |
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r**********n
发帖数: 9 | 8 常见的小儿后颅腔脑肿瘤有：
1．pilocytic astrocytoma：手术可以治愈。
2．Medulloblastoma：手术可以全部切除。再放疗。可能复发。
看有没有脑积水，这些病人一般都会有脑积水的。如果有脑积水，先治疗脑积水。因为
脑积水是危急情况。处理了脑积水，可以缓解症状。
MRI可以告诉我们肿瘤是否从脑干长出来的。常见的小儿脑肿瘤多半不是从脑干长出来
的。可能是在第四脑室内或是从小脑长出来的。有可能的话发几张MRI图像看看。
做全脊柱MRI，看有没有脊椎管转移。
只要肿瘤不是在脑干里面。手术都是可行的。后果也不错。
没有理由放弃。特别是诊断都不清楚。
在北京，上海，这不应该是很难的。 |
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t******n
发帖数: 2939 | 9 ☆─────────────────────────────────────☆
amandaYANG (绵熊) 于 (Wed Oct 23 20:09:45 2013, 美东) 提到:
小孩目前在上海儿童医学中心PICU，影响到咽喉神经，左脸会有瘫迹象，痰多治疗中，
肿瘤很大位置不好，但不想就这么放弃羊羊了，求问能帮忙直接联系到神经外科专家吗
？
☆─────────────────────────────────────☆
nabla (nabla) 于 (Wed Oct 23 20:44:59 2013, 美东) 提到:
So sad. I transfered this to Medicalpractice ban for you.
☆─────────────────────────────────────☆
babyrabbit (兔子) 于 (Wed Oct 23 20:49:16 2013, 美东) 提到:
多联系国内的医院吧，美国医生不一定更好。
☆─────────────────────────────────────☆
day... 阅读全帖 |
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H*Q
发帖数: 725 | 10 will send you 2 baozi as my appreciation
Brain Tumor Pathol. 2009;26(1):1-5. Epub 2009 Apr 30.
Hemorrhagic onset of pilocytic astrocytoma and pilomyxoid astrocytoma.
Shibahara I, Kanamori M, Kumabe T, Endo H, Sonoda Y, Ogawa Y, Watanabe M,
Tominaga T.
email, h********[email protected]
thanks |
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r**********n
发帖数: 9 | 11 这个估计是一种最良性儿童脑肿瘤。应该是“少年毛细胞星形细胞瘤”英文Juvenile
Pilocytic Astrocytoma。手术可以治愈。国内脑外科应该可以胜任。 |
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G*********y
发帖数: 100 | 12 glioblastoma是astrocytoma的一种。
astrocytoma就是从astrocyte来源的肿瘤，GFAP阳性。
成人的Glioblastoma multiforme (grade IV astrocytoma)
儿童的Pilocytic (low-grade) astrocytoma
是FA上需要掌握的两种astrocytoma，成人的恶性程度很高。
astrocyte就是一种Glial cells，所以你看GBM的名字就可以理解了。 |
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