de Souza Heider Lopes, Ramos Ana Maria de Oliveira, Ramos Carlos Cesar Formiga, Melo Syomara Pereira da Costa, Pereira Hougelle Simplício Gomes, Madureira João Flávio Gurjão, de Lana Janaína Martins
Serviço de Neurocirurgia, Hospital Universitário Onofre Lopes, Universidade Federal do Rio Grande do Norte, Brasil.
Arq Neuropsiquiatr. 2003 Mar;61(1):125-8. doi: 10.1590/s0004-282x2003000100026. Epub 2003 Apr 16.
Intracranial schwannoma not related to cranial nerves are unusual and rarely found in the subfrontal region. We report a case of olfactory groove schwannoma in a 27-year-old male, who presented with anosmia and headache initiated one year ago. At admission, bilateral papilledema was noted with absense of motor deficits or cranial nerves abnormalities. Cranial computed tomography (CT) revealed a bifrontal multicystic isodense enhancing mass lesion causing a frontal ventricular horn compression. Radiological features resembled that of a cystic olfactory groove meningioma. Decompressive bifrontal craniotomy was done. One month later, CT demonstrated a homogeneously contrast-enhancing mass in the olfactory groove region who extended into the left nasal cavity. Magnetic resonance imaging did not add more informations. A second surgical procedure was done through a nasoethmoidal approach with incomplete resection of the lesion. The complete tumor resection was only possible in a third surgery through another bifrontal approach. The hystopathological diagnosis of schwannoma was performed by conventional methods and confirmed by immunohistoquemical staining for S-100 protein. The rarity of this tumor and his clinical, radiological and histological aspects justify this publication.
非起源于颅神经的颅内神经鞘瘤较为罕见,且很少出现在额叶下区域。我们报告一例27岁男性嗅沟神经鞘瘤病例,患者于1年前开始出现嗅觉丧失和头痛症状。入院时,发现双侧视乳头水肿,但无运动功能障碍或颅神经异常。头颅计算机断层扫描(CT)显示双侧额叶多囊性等密度强化肿块,压迫额叶脑室角。影像学特征类似囊性嗅沟脑膜瘤。遂行双侧额叶减压开颅手术。1个月后,CT显示嗅沟区域有均匀强化肿块,延伸至左侧鼻腔。磁共振成像未提供更多信息。通过鼻筛入路进行了第二次手术,但肿瘤切除不完全。第三次手术通过另一种双侧额叶入路才实现了肿瘤的完整切除。通过传统方法进行了神经鞘瘤的组织病理学诊断,并通过S-100蛋白免疫组织化学染色得以证实。鉴于该肿瘤的罕见性及其临床、影像学和组织学特征,特此发表本病例报告。