摘要
目的 分析成人枕叶非典型脉络丛乳头状瘤(ACPP)术后复发为脉络丛癌(CPC)患者的临床表现、影像学特点和治疗方法。方法 回顾性分析1例成人脑枕叶ACPP术后复发为CPC患者的临床资料,并复习相关文献。结果 头颅MRI平扫及增强扫描示:右侧枕叶侧脑室后角旁见大小约3.4 cm×4.5 cm×4.5 cm(左右×前后×上下)占位,呈不规则块状,等T_(1)、T_(2)信号,边缘见短T_(1)、T_(2)信号,周边伴有稍长T_(1)、T_(2)信号,DWI呈局部高信号,T_(2)Flair呈周围高信号,增强后病灶明显强化,其内见无强化区。气管插管全身麻醉下行枕叶占位显微镜下全切,术中见部分肿瘤组织侵犯侧脑室枕角。术后病理结果示:枕叶肿瘤组织为CPC,WHOⅢ级,侵犯侧脑室肿瘤组织为脉络丛乳头状瘤(CPP),WHO I级。术后接受瘤腔放射治疗,随访1.5 a无复发。结论 脑实质内CPC是一种高度恶性肿瘤,是ACPP术后的原位复发,无特殊临床表现及影像学特征。病理学为诊断“金标准”,手术切除联合局部放疗是可能有效的治疗方法。
Objective Analyze the clinical characteristics,imaging features and treatments of recurrence as choroid plexus carcinoma after surgery of adult occipital atypical choroid plexus papilloma,to provide a reference for the diagnosis and treatment of the disease.Methods Clinical data in a recurrence as choroid plexus carcinoma after surgery of an adult occipital atypical choroid plexus papilloma case were collected and analyzed,and the relative literatures were reviewed.Results A 56-year-old female patient was admitted to the hospital with"intermittent headache and numbness in the limbs for about 5 days",whose right occipital lobe ACPP was surgically removed and the radiation therapy was performed after surgery 4 years ago.The results of head magnetic resonance imaging(MRI)showed a 3.4 cm×4.5 cm×4.5 cm irregular mass in right occipital lobe nearby the posterior angle of lateral ventricular with inheterogeneous isointensity on T_(1)WI and T_(2)WI,hyperintensity on TIWI and hyperintensity on T_(2)WI are visible in the surroundings,partly hyperintensity on DWI.The enhanced scanning showed significantly strengthened of the lesion with reinforcement zone inside it.The occipital tumor was resected completely under microscope,general anaesthesia with tracheal intubation.some tumor tissue was seen invading the occipital angle of the lateral ventricular.The pathological diagnosis was CPC(WHO III)of the occipital lobe tumor,but CPP(WHO I)of the tissue invading the lateral ventricular.The tumor cavity received radiotherapy after operation and was followed up for 1.5 years without recurrence.Conclusion CPC in the brain lobes is a kind of malignant tumor without specific imaging features and clinical characteristics,it can recur in situ after surgical resection of ACPP,pathological diagnosis is the gold standard for the diagnosis,and the surgical resection combined with local radiotherapy may be an effective treatment.
作者
奚再兴
孙含蓄
何小姣
王博
Xi Zaixing;Sun Hanxu;He Xiaojiao;Wang Bo(The first people’s hospital of Nanyang,department of neurosurgery,Nanyang 473000,China;The first people’s hospital of Nanyang,Gastroenterology,Nanyang 473000,China;The first people’s hospital of Nanyang,Department of Pathology,Nanyang 473000,China)
出处
《河南外科学杂志》
2023年第2期18-21,共4页
Henan Journal of Surgery
关键词
脉络丛乳头状瘤
非典型脉络丛乳头状瘤
脉络丛癌
脉络丛肿瘤
病例报告
Choroid plexus papilloma
atypical choroid plexus papilloma
choroid plexus carcinoma
choroid plexus tumors
case reports
