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原发于颅内的恶性星形细胞瘤或胶质母细胞瘤向颅外骨转移非常罕见。作者报告一例。女,35岁,因头痛、恶心一个月及近期内复视于1981年9月就诊。检查见右外展神经麻痹,CT扫描显示右额叶有一大块囊状的低密度区,侧脑室前角明显向对侧移位,提示为一囊性星形细胞瘤。颈动脉造影未见恶性循环征象。同位素脑扫描显示右额叶病变。同月行手术切除,为一内含清亮黄色液体的囊状肿瘤。光镜显示肿瘤细胞和血管丰富,其周有微小囊,肿瘤中心细胞明显增加,且同成团的微血管向大园形星形细胞转变。可见明显的多形细胞,偶见巨细胞及环状细胞。少数呈丝状分裂,尤以瘤中心部位为主。未见肿瘤坏死及内皮增生。血管形状、明显的细胞变化及丝状分裂均表明为一正在恶性变的星形细胞瘤。术后施行放疗,患者近一年正常。于1982年8月出现胸椎痛及尿潴留,脊髓腔造影显示T_6平面硬脊膜外受
Intracranial malignant astrocytoma or glioblastoma metastases to the extracranial bone are very rare. The author reported one case. Female, 35 years old, presented in September 1981 for headache, nausea, and diplopia in the near future. Examination showed right abducens nerve palsy. CT scan revealed a large cystic low density area in the right frontal lobe. The anterior horn in the lateral ventricle was significantly shifted to the contralateral side, suggesting a cystic astrocytoma. No vicious circle signs were seen in the carotid angiography. Isotope brain scans show right frontal lobe lesions. In the same month, surgical resection was performed as a cystic tumor containing a clear yellow liquid. Light microscopy showed that the tumor cells and blood vessels were abundant, there were tiny cysts around the tumor, and the central cells of the tumor increased significantly, and the same group of micro-vessels turned into large round-shaped stellate cells. Visible polymorphous cells, occasionally giant cells and circular cells. A small number of filamentous divisions, especially in the central part of the tumor. No tumor necrosis and endothelial hyperplasia were seen. The shape of the blood vessels, obvious cell changes, and filamentous divisions all indicate a malignant astrocytoma. Radiotherapy was performed after the operation and the patient was normal for nearly one year. Thoracic pain and urinary retention occurred in August 1982. Spinal angiography showed T_6 plane epidural