Hiyama H, Kubo O, Nakajima H, Hayashi M, Kagawa M
Department of Neurosurgery, Tokyo Women's Medical College.
No Shinkei Geka. 1992 Nov;20(11):1199-204.
A case of cystic optic glioma involving chiasma and bilateral posterior optic pathway was reported. A 26-year-old male was admitted to our hospital complaining of dysarthria and left hemiparesis. CT, MRI revealed a cystic tumor at the right basal ganglia to midbrain, a calcified one at the bilateral optic tract and left temporal to thalamic region, and a small one at the chiasma. Radiotherapy and chemotherapy were performed because anaplastic astrocytoma was suspected after stereotactic biopsy of the tumor at the right basal ganglia. The subsequent MRI showed continuity among the above three lesions to be well defined. About 2 years later, however, enlargement of the cyst, tumor invasion beyond the optic pathway and growth of the chiasmal lesion were noted, and direct surgery to the chiasmal lesion was performed. The chiasma was swollen and grayish soft tumor tissue was partly resected after aspiration of the intrachiasmal cyst. The definitive pathological diagnosis was pilocytic astrocytoma. This case was designated as a peculiar optic glioma in the following respects; the patient was an adult man suffering from dysarthria and left hemiparesis, the tumor involved not only the chiasma and the bilateral optic tract, but also the outside optic pathway and was accompanied by a large cyst.
报告了一例累及视交叉和双侧视路后部的囊性视神经胶质瘤。一名26岁男性因言语不清和左侧偏瘫入院。CT、MRI显示右侧基底节至中脑有一个囊性肿瘤，双侧视束及左侧颞叶至丘脑区域有一个钙化肿瘤，视交叉处有一个小肿瘤。因对右侧基底节区肿瘤进行立体定向活检后怀疑为间变性星形细胞瘤，遂进行了放疗和化疗。随后的MRI显示上述三个病变之间的连续性清晰。然而，约2年后，发现囊肿增大、肿瘤侵犯超出视路且视交叉病变生长，遂对视交叉病变进行了直接手术。视交叉肿胀，抽吸视交叉内囊肿后部分切除灰白色软肿瘤组织。最终病理诊断为毛细胞型星形细胞瘤。该病例在以下方面被认定为特殊的视神经胶质瘤：患者为成年男性，有言语不清和左侧偏瘫，肿瘤不仅累及视交叉和双侧视束，还累及视路外侧并伴有一个大囊肿。
