I-medulloblastoma ngumhlobo womhlaza wengqondo. Umdlavuza wobunongo ngumsila ebuchosheni. Ngokuqhelekileyo, izicubu zengqondo zivela kwiingqondo ngokwazo, okanye zivela kwindawo eyahlukileyo kunye ne-metastasize (ukusasazeka) kwingqondo. I-medulloblastoma ngenye yeengcambu zengqondo ezivela kwingqondo ngokwazo, kwingingqi ebizwa ngokuba yi-brainstem.
Iimpawu
Kukho iintlobo zeempawu ze-medulloblastoma. Ezi ziquka:
- Intloko
- Utywala
- Ubhaliso obubi kunye nokulungelelaniswa
- Ubuqili
- Ukunyuka kwamehlo okungavamile
- Umbono ogqityiweyo okanye umbono obini
- Ubuthathaka obusweni okanye ubunzima bombuso okanye ijwabu leso
- Ubuthathaka okanye ukuphazamiseka kwelinye icala lomzimba
- Ukulahleka kwengqondo
Iimpawu ze-medulloblastoma ziyakwenzeka ngenxa yomonakalo we-cerebellum okanye uxinzelelo kwizakhiwo ezikufuphi zengqondo, ezifana ne-brainstem, okanye ngenxa ye- hydrocephalus (uxinzelelo olungaphezulu komthamo kwiqondo.)
Umvelaphi
I-medulloblastoma ivela kwi-cerebellum, ehlala kwingingqi yekhanda elichazwe njenge-post fossa. Lo mmandla awubandakanyi nje kuphela i-cerebellum kodwa kwakhona i-brainstem.
Ulawulo lwe-cerebellum ulinganiso kunye nokulungelelanisa kwaye lufumaneka emva kwengqondo. I-brainstem iquka i-midbrain, i-pons, kunye ne-medulla kwaye ivumela uxhulumano phakathi kwengqondo kunye nalo lonke umzimba kunye nokulawula imisebenzi ebalulekileyo njengokuphefumula, ukugwinya, ukuvutha kwentliziyo kunye negazi.
Njengoko i-medulloblastoma ikhula ngaphakathi kwe-cerebellum, inokunyanzelisa iipon kunye / okanye i-medulla ebangela iimpawu ezingaphezulu kweengxaki zegazi, kubandakanywa nembono kabini, ubuthathaka obusweni, kunye nokuncipha kwengqondo. Iisondlo eziseduze nazo zinokunyanzeliswa yi-medulloblastoma.
Hydrocephalus
I-buildup ye-Fluid evelisa uxinzelelo kwingqondo yenye yeempawu ze-medulloblastoma, nangona kungekhona wonke umntu onesifo se-medulloblastoma esenza i-hydrocephalus.
I-post fossa, engummandla apho i-brainstem kunye ne-cerebellum ifumaneka khona, inondliwa luhlobo olukhethekileyo lwe-CSF (i-cerebrospinal fluid), njengawo wonke ubuchopho. Lo mkhuhlane ugeleza kuyo yonke indawo efaka ingqungquthela kunye nengqungquthela. Kwiimeko eziqhelekileyo, akukho miqobo ekhoyo kule ndawo.
Ngokuqhelekileyo, i-medulloblastoma igqithise ngokugqithiseleyo i-cerebrospinal fluid, edala ukugqithisa ngokugqithiseleyo kunye nokujikeleza kwengqondo. Oku kubizwa ngokuthi i-hydrocephalus. I-Hydrocephalus inokubangela iintlungu zentloko, iimpawu ze-neurological and uthargy. Umonakalo we-neurological ungabangela ukukhubazeka okusisigxina nokukhubazeka.
Ukususwa kwe-fluid excessively kuyadingeka. Ukuba i-fluid idinga ukususwa ngokuphindaphindiweyo, i- VP (ventriculoperitoneal) shunt ingafuneka . I-VP shunt yiphubhu engakwazi ukuhlinzwa ngokugqithiseleyo kwingqondo ngokukhawuleza ukunciphisa uxinzelelo oluninzi lwe-fluid.
Ukuxilongwa
Ukuxilongwa kwe-medulloblastoma kuncike kwiindlela eziliqela, eziqhelekileyo zisetyenziswa ngokudibanisa.
Nangona unempawu eziqhelekileyo ezihambelana ne-medulloblastoma, kunokwenzeka ukuba awuyiyo i-medulloblastoma-kuba isifo esingaqhelekanga.
Nangona kunjalo, ukuba unayo nayiphi na impawu yempawu ye-medulloblastoma, kubalulekile ukumbona ugqirha wakho ngokukhawuleza ngenxa yokuba imbangela ingaba yi-medulloblastoma okanye enye imeko ebalulekileyo yengqondo.
- Imbali kunye novavanyo lomzimba: Ugqirha wakho uza kukubuza imibuzo ecacileyo malunga nezikhalazo zakho. Ngethuba lokutyelela unyango, ugqirha wakho uya kwenza uvavanyo olwenziwe ngokusemgangathweni, kunye nokuhlolwa kweengxelo ze-neurological. Iziphumo zembali yakho yonyango kunye nokuhlolwa kwangokwenyama kunokukunceda ekucaciseni amanyathelo alandelayo ekuhlaleni ingxaki yakho.
- Iingcamango zobungqina : Ukuba imbali yakho kunye nomzimba uyaphakamisa i-medulloblastoma, ugqirha wakho unokwenza ukuba ufunde izifundo zengqondo, ezifana ne-Brain MRI. Ingqondo ye-MRI inganikeza umfanekiso omhle we-post fossa yengqondo, leyo indawo apho i-medulloblastoma iqala ukukhula.
- I-Biopsy: I-biopsy yindlela yokucoca ukukhula okanye isisu ngenxa yenjongo yokujonga iisisusi ezisusiweyo phantsi kwe-microscope. Iziphumo ze-biopsy zisetyenziselwa ukunceda ukufumana amanyathelo alandelayo. Ngokuqhelekileyo, ukuba kukho ukuba une-tumor eneziganeko ze-medulloblastoma, mhlawumbi uya kuvavanywa ukuba ususwe ngokugqithisileyo kwe-tumor, kungekhona i-biopsy. I-biopsy ibandakanya kuphela ukususwa kwexabiso elincinci leethambo. Ngokuqhelekileyo, ukuba unako ukuhlinzwa ngokukhuselekileyo, ukususwa kwe-tumor enkulu kunokwenzeka kunconywa.
Yintoni ongayilindela
I-Medulloblastoma ithathwa njengomhlaza obulalayo, oko kuthetha ukuba unokusasazeka. Ngokuqhelekileyo, i-medulloblastoma isasazeka kuyo yonke ingqondo kunye nomgudu, kubangela iimpawu ze-neurological. Ngokungaqhelekanga isasazeka kwezinye iindawo zomzimba ngaphandle kwenkqubo ye-nervous.
Unyango
Kukho iindlela ezininzi ezisetyenziselwa ukunyanga i-medulloblastoma, kwaye ziqhelekileyo zisetyenziselwa ukudibanisa.
- Ugqirha : Ukuba wena okanye wakho umthandayo unomculo we-medulloblastoma, ukukhutshwa ngokugqithiseleyo kokukhutshwa kwe-tumor kuyanconywa. Uya kufuneka ube neemvavanyo zokucinga ngeengqondo kunye nokuvavanywa kwangaphambili phambi kokuhlinzwa.
- I-Chemotherapy : I-Chemotherapy ineemithi ezinamandla ezisetyenziselwa ukutshabalalisa amangqamuzana omhlaza. Oku kuhloswe ukuqeda okanye ukunciphisa ubuninzi be-tumor ngangokunokwenzeka, kubandakanywa nemimandla yesifo esinokusasazeka kwi-tumor yokuqala. Kukho imithi ehlukahlukeneyo ye-chemotherapeutic, kwaye ugqirha wakho uya kugqiba inhlanganisela efanelekileyo kuwe ngokusekelwe kwimibala enobunzima besifo, ubukhulu besisu, ukuba lide kangakanani, kunye nobudala bakho. I-Chemotherapy inokuthi ithathwe ngomlomo, IV (nge-intravenously) okanye nge-intrathecally (injected ngqo kwi-system ye-nervous.)
- Izaphulo : Ukusetyenziswa kwamayeza aqhelekileyo kusetyenziswa unyango lomhlaza, kuquka ne-medulloblastoma. Imijelo ejoliswe kuyo ingayithunyelwa kwingingqi yecumbo ukuze incedise ukunciphisa ubukhulu nokukhusela ukuphindaphinda.
Prognosis
Ngonyango, ukusinda kwabantu abaneminyaka emi-5 abafunyaniswa ne-medulloblastoma kuyahluka kuye kuxhomekeka kwizinto ezininzi ezibandakanya:
- Ubudala : Iintsana ezineminyaka engaphantsi kwe-1 ziqikelelwa ukuba zinama-30 ekhulwini kwi-5 yokuphila, ngelixa abantwana banama-60 ukuya kuma -80 ekhulwini. Abantu abadala baqikelelwa ukuba malunga nama-50-60 ekhulwini kwi-5 ubudala yokuphila, kunye nabantu abadala abadala bafumana ukuphucula okungcono kunye nokuphila kunabantu abadala.
- Ubungakanani be-tumor : Izidumbu ezincinci ngokubanzi zidibaniswa neziphumo ezingcono kunokuba ziyi-tumors ezinkulu.
- Ukuqhaqhaza kwandwendwela: Izidumbu ezingazange zisasaze ngaphaya kwendawo yokuqala zidibene neziphumo ezingcono kunezicubu eziye zasasazeka.
- Ingaba i-tumor yonke ingasuswa ngexesha lotyando: Ukuba isalathisi sonke sisuswe, kunethuba elingaphantsi lokuphindaphinda kunye nethuba elingcono lokusinda kunezinto ezibonakalayo xa kusekho i-tumor ehlalayo emva kokuhlinzwa. Isizathu sokuba isisu singenakususwa ngokupheleleyo kukuba sinokuxinana kakhulu kunye okanye singeniswe nommandla wengqondo ebalulekileyo ekusindeni.
- Ubunzima be-tumor esekelwe kwi-pathology (uviwo phantsi kwe-microscope): Nangona i-biopsy ayilona isinyathelo sokuqala xa i-medulloblastoma isuswe, ingahlolwa kunye ne-microscope ukuba ikhangele iimpawu ezicacileyo, ezinokukunceda ukukhokela izigqibo malunga nemitha kunye ne-chemotherapy.
Ubudala bexesha kunye neNzeka
I-Medulloblastoma yiyona nto ixhaphakileyo yengqondo yengqondo ebantwini, kodwa kusekho into engaqhelekanga, kwanabantwana.
- Abantwana : Ubunzima bokuxilonga buphakathi kweminyaka yobudala engama-5 ukuya kwe-10 ubudala, kodwa kungenzeka kwiintsana nakwishumi elivisayo. Ngokubanzi, i-medulloblastoma iqikelelwa ukuba ichaphazele malunga nabantwana aba-4-6 kwisigidi e-United States naseKhanada, malunga nabantwana abangaba ngu-500 abafumana i-medulloblastoma e-United States minyaka yonke.
- Abantu abadala : I-Medulloblastoma iyisisu esingaqhelekanga kubantu abadala abangaphantsi kweminyaka engama-45, kwaye ayifani ncinane emva koko. Phantse iipesenti zeengcambu zengqondo kubantu abadala zilapha i-medulloblastoma.
Genetics
Ininzi yexesha, i-medulloblastoma ayinxulumene nayiphi na ingozi, kuquka i-genetics. Nangona kunjalo, kukho iimbalo ezimbalwa ze-genetic syndromes ezinokudityaniswa nesiganeko sokwanda kwe-medulloblastoma, kuquka i-Gorlin syndrome kunye ne-Turcot syndrome.
ILizwi
Ukuba wena okanye wakho othandekayo ufumene unyango okanye unyango lwe-medulloblastoma, ingaba yinto enzima kakhulu. Iyakwazi ukuphazamisa imisebenzi eqhelekileyo yokuphila njengesikolo kunye nomsebenzi. Ukuba ufumana i-tumor ukuphindaphinda, kuya kufuneka ufumane unyango kwakhona. Le nkqubo yokubuyisela ingathatha iminyaka embalwa kwaye iquka ukunyanga kwimizimba kunye nokusebenza.
Abantwana abaninzi kunye nabantu abadala bayaphuma kwi-medulloblastoma kwaye bafumane amandla okuphila ubomi obuqhelekileyo novelisayo. Unyango lwezonyango ezininzi zezicubu ziphucula ngokukhawuleza, okwenza umphumo ube bhetele kwaye unyango lubekezeleleke.
> Imithombo:
> Kramer K, Pandit-taskar N, Humm JL, et al. Ucwaningo lwesigaba II senomathotholo nge-intraventricI-3F8 ye-medulloblastoma. Isifo seMhlaza yegazi. 2018; 65 (1)
> Johnston DL, uKeene D, uKostova M, et al. Ingozi ye-medulloblastoma e-Canada abantwana. J Neurooncol. 2014; 120 (3): 575-9.
> Atalar B, Ozsahin M, Shayela J, et al. Impembelelo yonyango kunye neziganeko zokuxela izigulane zabantu abadala abane-medulloblastoma: I-Rare Cancer Network (RCN). I-Oncol Radiother. 2018;