一例成人H3IDH野生型弥漫性儿童型高级别脑胶质瘤的多学科诊疗

A Multidisciplinary Diagnosis and Treatment of an Adult Case of H3-/IDH-Wild-Type Diffuse Pediatric-Type High-Grade Glioma

  • 摘要: “弥漫性儿童型高级别胶质瘤(diffuse paediatric-type high-grade glioma,pHGG),H3/异柠檬酸脱氢酶(isocitrate dehydrogenase, IDH)野生型”是一种世界卫生组织(World Health Organization, WHO)4级弥漫性胶质瘤,具有恶性组织学特征,多见于儿童、青少年。本多学科诊疗病例为1例24岁青年女性患者,经穿刺活检初步诊断,同步放化疗缩小肿瘤范围后,行肿瘤全切术,术后替莫唑胺联合瑞戈非尼辅助治疗,复发后经再次切除联合二次放疗,最终病情仍快速进展,患者生存期超过32个月。pHGG恶性程度高、侵袭性强、预后差,需多学科紧密协作以实现精准诊断与个体化干预,体现了多学科诊疗模式的重要价值。

     

    Abstract: Diffuse pediatric-type high-grade glioma (pHGG), H3- and isocitrate dehydrogenase (IDH)-wild-type, is a World Health Organization (WHO) grade 4 diffuse glioma with malignant histological features, which typically affects in children and adolescents. This multidisciplinary treatment case involves a 24-year-old young female patient initially diagnosed via biopsy. After concurrent chemoradiotherapy reduced the tumor size, complete resection was achieved, followed by adjuvant therapy with temozolomide and regorafenib. After recurrence, the tumor was resected again, and a second course of radiotherapy was administered, but the disease ultimately progressed rapidly, with an overall survival exceeding 32 months. pHGGs are highly malignant, aggressive, and associated with poor prognosis. Accurate diagnosis and targeted intervention require close collaboration among a multidisciplinary team, which highlights the critical value of multidisciplinary manage-ment in clinical practice.

     

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