neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"10.17650/1683-3295-2024-26-3-79-88neurosurgery-1573Research ArticleНАБЛЮДЕНИЕ ИЗ ПРАКТИКИFROM PRACTICEТератома III желудочка со злокачественной трансформациейThird ventricle teratoma with malignant transformationhttps://orcid.org/0000-0001-6403-4910АкчуринаЮ. Р.AkchurinaYu. R.

Юлия Ринатовна Акчурина

127473 Москва, ул. Делегатская, 20, стр. 1

Bld. 1, 20 Delegatskaya St., Moscow 127473

julia.akchurina@gmail.comhttps://orcid.org/0000-0002-7629-7934ГорожанинВ. А.GorozhaninV. A.

127543 Москва, ул. Мурановская, 5

5 Muranovskaya St., Moscow 127543

https://orcid.org/0000-0002-2864-9675ШатохинТ. А.ShatokhinT. A.

117997 Москва, ул. Островитянова, 1;

125367 Москва, Волоколамское шоссе, 80;

129090 Москва, Большая Сухаревская пл., 3

1 Ostrovityanova St., Moscow 117997;

80 Volokolamskoye Shosse, Moscow 125367;

3 Bolshaya Sukharevskaya Sq., Moscow 129090

https://orcid.org/0000-0003-4518-9874ЛукьянчиковВ. А.LukyanchikovV. A.

117997 Москва, ул. Островитянова, 1;

125367 Москва, Волоколамское шоссе, 80;

129090 Москва, Большая Сухаревская пл., 3

1 Ostrovityanova St., Moscow 117997;

80 Volokolamskoye Shosse, Moscow 125367;

3 Bolshaya Sukharevskaya Sq., Moscow 129090

ФГБОУ ВО «Российский университет медицины» Минздрава РоссииРоссияRussian University of Medicine, Ministry of Health of RussiaRussian FederationМедицинский центр «UNIКЛИНИК»РоссияMedical Center “UNIKLINIK”Russian FederationФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России; ФГБНУ «Научный центр неврологии»; ГБУЗ г. Москвы «Научно-исследовательский институт скорой помощи им. Н.В. Склифосовского Департамента здравоохранения г. Москвы»РоссияN.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia; Research Center of Neurology; N.V. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare DepartmentRussian Federation2024070920242637988Copyright © Акчурина Ю.Р., Горожанин В.А., Шатохин Т.А., Лукьянчиков В.А., 20242024Акчурина Ю.Р., Горожанин В.А., Шатохин Т.А., Лукьянчиков В.А.Akchurina Y.R., Gorozhanin V.A., Shatokhin T.A., Lukyanchikov V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/1573

Герминативноклеточные опухоли (ГКО) центральной нервной системы представляют собой редкую и гетерогенную группу первичных опухолей головного мозга, встречающихся в основном в педиатрической популяции и у лиц молодого возраста. Вопросы этиологии и оптимальный протокол лечения ГКО центральной нервной системы остаются спорными. Выбор схемы лечения определяется подтипом ГКО, однако может варьировать в зависимости от учреждения и специалиста. Для подтверждения диагноза негерминомных герминативноклеточных опухолей (НГГКО) центральной нервной системы часто требуется выполнение биопсии в сочетании с хирургической резекцией с последующим проведением химио- и лучевой терапии. Объем хирургической резекции является важным прогностическим фактором наряду с этиологией и генетическими параметрами НГГКО. В статье представлен редкий клинический случай быстрорастущей тератомы задних отделов III желудочка у 17-летнего юноши с симптомами внутричерепной гипертензии. Тотальной хирургической резекции предшествовала эндоскопическая тривентрикулоцистерностомия. При иммуногистохимическом исследовании выявлено наличие клеток эмбриональной карциномы и незрелой тератомы, соответственно, опухоль отнесена к разряду смешанных ГКО с неблагоприятным прогнозом. Несмотря на тотальную резекцию опухоли и своевременно начатую адъювантную терапию, спустя 3,6 мес после оперативного лечения отмечено быстропрогрессирующее течение заболевания с дальнейшим неблагоприятным исходом.

Intracranial germ cell tumors(GCTs) are rare and heterogeneous group of primary brain tumors, mainly affecting pediatric population and young adults. The current understanding of the etiology of intracranial GCTs and their optimal management strategies remain controversial. Treatment plans differ depending on the subtype GCT and may vary among physicians and institutions. Central nervous system non-germinomatous germ cell tumor (NGGCT) usually requires surgical resection with histological verification, chemotherapy, and radiation. The extent of surgical resection is an important prognostic factor alongside the etiology and genetics of NGGCT. This article presents a rare clinical case of a rapidly growing teratoma located in the posterior part of third ventricle of a 17-year-old male presenting with symptoms of intracranial hypertension. Surgical total resection was preceded by endoscopic third ventriculostomy. Immunohistochemistry revealed the presence of embryonal carcinoma and immature teratoma cells turning the tumor into mixed type NGGCT with unfavorable prognosis. Despite the complete resection of the tumor and the timely initiation of adjuvant therapy, a rapid progression of the disease with subsequent unfavorable outcome was observed 3.6 months after the surgical treatment.

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The authors declare that there are no conflicts of interest present.