Inci Servet, Gülşen Salih, Söylemezoglu Figen, Kansu Tulay, Ozgen Tuncalp
Department of Neurosurgery, School of Medicine, University of Hacettepe, Ankara, Turkey.
Surg Neurol. 2004 Apr;61(4):384-90; discussion 390. doi: 10.1016/S0090-3019(03)00291-X.
Granular cell tumors in the central nervous system are quite rare. To date, only 6 cases of granular cell tumor arising from cranial nerves have been reported in the literature. To the best of our knowledge, we present the first case of a predominant intracavernous granular-cell tumor arising from oculomotor nerve.
A 42-year-old man presented with third-nerve paresis and decreased visual acuity on the left side. Magnetic resonance imaging showed a mainly intracavernous mass partially extending to the superior orbital fissure and entrance of the optic canal. Using a pterional craniotomy, the tumor was removed from within the cavernous sinus via combined superior and lateral intradural approach, and optic nerve was also decompressed. Histologically, the tumor was diagnosed as a granular cell tumor.
Although it is quite rare, granular cell tumor should be included into the differential diagnosis of intracavernous masses because surgical treatment is curative.
中枢神经系统颗粒细胞瘤十分罕见。迄今为止,文献中仅报道过6例起源于颅神经的颗粒细胞瘤。据我们所知,我们报告了首例主要位于海绵窦内、起源于动眼神经的颗粒细胞瘤。
一名42岁男性,出现左侧动眼神经麻痹和视力下降。磁共振成像显示一个主要位于海绵窦内的肿块,部分延伸至眶上裂和视神经管入口。采用翼点开颅术,通过联合硬膜内上入路和侧入路从海绵窦内切除肿瘤,并对视神经进行减压。组织学检查诊断该肿瘤为颗粒细胞瘤。
尽管颗粒细胞瘤非常罕见,但因其手术治疗可治愈,故应纳入海绵窦内肿块的鉴别诊断。