Chung D S, Park Y S, Lee J H, Kang J K
Department of Neurosurgery, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Neurosurgery. 1999 Aug;45(2):376-8. doi: 10.1097/00006123-199908000-00036.
Of the primary intracranial mucoceles, those arising from the optic canal or anterior clinoid process are extremely rare. To our knowledge, only five cases have been reported. The pathogenesis of mucoceles at this unusual site is unclear, but the previously reported cases suggest that these mucoceles may originate from pneumatizing air cells in the anterior clinoid processes.
A 43-year-old woman presented with diplopia. Magnetic resonance imaging showed a small mass, compressing the optic nerve, in the medial portion of the left anterior clinoid process. The medial portion of the anterior clinoid process surrounding the mass was eroded and the bony margins of the mass were well corticated in computed tomographic scans. There was no direct connection between any paranasal sinus and the mass cavity, as assessed in imaging studies and intraoperatively confirmed. The pathological diagnosis after the operation indicated a mucocele.
Considering the absence of air cells in the anterior clinoid processes, the mucocele in this case might have originated from ectopic mucinous tissue that appeared during the development of the optic canal, rather than from a pneumatizing air cell.
在原发性颅内黏液囊肿中，起源于视神经管或前床突的极为罕见。据我们所知，仅有5例相关报道。这种罕见部位黏液囊肿的发病机制尚不清楚，但既往报道的病例提示，这些黏液囊肿可能起源于前床突内的含气小房。
一名43岁女性因复视就诊。磁共振成像显示左前床突内侧有一小肿块压迫视神经。计算机断层扫描显示，肿块周围的前床突内侧部分被侵蚀，肿块的骨质边缘有良好的骨皮质。影像学检查及术中证实，鼻窦与肿块腔之间无直接连通。术后病理诊断为黏液囊肿。
鉴于前床突内不存在含气小房，该病例中的黏液囊肿可能起源于视神经管发育过程中出现的异位黏液组织，而非含气小房。
