Thomé C, Grobholz R, Boschert J, Schmiedek P
Department of Neurosurgery, Universitaetsklinikum Mannheim, University of Heidelberg, Germany.
Acta Neurochir (Wien). 2003 Apr;145(4):309-13; discussion 313. doi: 10.1007/s00701-002-1059-6.
Meningiomas arising from cranial nerves with no dural attachment are exceedingly rare. The authors present a patient with bilateral meningiomatous lesions originating symmetrically from both spinal accessory nerves.
A 61-year old woman presented with a one-year history of spinal ataxia and minimal left-sided motor impairment. Magnetic resonance imaging demonstrated two extrinsic lesions dorsolaterally of the medulla. Surgical exposure via a midline suboccipital approach with C1 laminectomy revealed the lesions arising from the spinal accessory nerves and in direct contact with the vertebral arteries. Histological investigation showed hypocellular fibrous lesions with proliferating meningothelial cells, psammoma bodies and immunoreactivity for vimentin, S-100 protein and epithelial membrane antigen.
To the authors' knowledge this is the first report of intradural tumours of the spinal accessory nerves not derived from Schwann cells and the first report of bilateral intracranial meningiomatous lesions without dural attachment.
起源于颅神经且无硬脑膜附着的脑膜瘤极为罕见。作者报告了一例双侧脑膜瘤性病变患者，病变对称起源于双侧副神经。
一名61岁女性，有一年脊髓性共济失调病史，左侧运动功能轻度受损。磁共振成像显示延髓背外侧有两个外在性病变。经枕下中线入路并切除C1椎板进行手术暴露，发现病变起源于副神经，且与椎动脉直接接触。组织学检查显示为细胞稀少的纤维性病变，伴有增生的脑膜上皮细胞、砂粒体，波形蛋白、S-100蛋白和上皮膜抗原呈免疫反应阳性。
据作者所知，这是首例非源自施万细胞的副神经硬膜内肿瘤报告，也是首例无硬脑膜附着的双侧颅内脑膜瘤性病变报告。
