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双侧侧脑室脉络丛乳头状瘤

Choroid plexus papilloma of bilateral lateral ventricle.

作者信息

Erman T, Göçer A I, Erdoğan S, Tuna M, Ildan F, Zorludemir S

机构信息

Department of Neurosurgery, Cukurova University, School of Medicine, Adana, Turkey.

出版信息

Acta Neurochir (Wien). 2003 Feb;145(2):139-43; discussion 143. doi: 10.1007/s00701-002-1047-x.

Abstract

BACKGROUND

Choroid plexus papillomas are rare, accounting for less than 1% of all intracranial tumours in adults. However, they are relatively more common in childhood and constitute 1.5 to 4% of intracranial tumours. They are most often located in the lateral ventricle, followed by the fourth and third ventricles and, rarely, in the cerebellopontine angle. Bilateral lateral ventricle choroid plexus papilloma is very rare and only a few cases has been reported.

CLINICAL PRESENTATION

A 3-year-old boy was admitted to our hospital with a history of irritability and vomiting. Neurological examination on admission was normal. A head computed tomographic scan and magnetic resonance imaging showed tumours in both lateral ventricles, hydrocephalus and a left temporal arachnoid cyst. The bilateral intraventricular mass enhanced densely and homogeneously. A presumptive diagnosis of choroid plexus papillomas was made.

INTERPRETATION

The initial surgery was performed for removal of the lesion in the right lateral ventricle, and 20 days later removal of the left lateral ventricle tumour was carried out. Bilateral temporoparietal craniotomy and total removal of tumours was performed. Hydrocephalus was controlled by total tumour resection from both sides. The histology of these tumours was the same and revealed choroid plexus papilloma. Interpretation: Bilateral choroid plexus papilloma is extremely rare and distinct from diffuse villous hypertrophy and their surgical approaches are different from each other. Differential diagnosis should be made by MRI preoperatively. If bilateral choroid plexus papilloma is detected, total surgical resection should be performed. Total surgical removal of the neoplasm not only cures the tumour but also may lead to complete resolution of the hydrocephalus.

摘要

背景

脉络丛乳头状瘤较为罕见,在成人颅内肿瘤中占比不到1%。然而,它们在儿童期相对更为常见,占颅内肿瘤的1.5%至4%。它们最常位于侧脑室,其次是第四和第三脑室,很少位于小脑桥脑角。双侧侧脑室脉络丛乳头状瘤非常罕见,仅有少数病例报道。

临床表现

一名3岁男孩因烦躁和呕吐病史入院。入院时神经学检查正常。头部计算机断层扫描和磁共振成像显示双侧侧脑室有肿瘤、脑积水和左侧颞部蛛网膜囊肿。双侧脑室内肿块强化浓密且均匀。初步诊断为脉络丛乳头状瘤。

解读

最初进行手术切除右侧侧脑室病变,20天后切除左侧侧脑室肿瘤。实施双侧颞顶开颅并完全切除肿瘤。通过双侧肿瘤全切控制了脑积水。这些肿瘤的组织学表现相同,显示为脉络丛乳头状瘤。解读:双侧脉络丛乳头状瘤极为罕见,与弥漫性绒毛肥大不同,其手术方法也彼此不同。术前应通过磁共振成像进行鉴别诊断。如果检测到双侧脉络丛乳头状瘤,应进行手术全切。肿瘤的手术全切不仅能治愈肿瘤,还可能使脑积水完全消退。

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