Dwarakanath Srinivas, Suri Ashish, Mahapatra Ashok Kumar, Mehta Veer Singh, Sharma Meher Chand
Department of Neurosurgery, Neurosciences Center, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
Neurosurgery. 2005 Apr;56(4):E869; discussion E869. doi: 10.1227/01.neu.0000156491.02087.83.
Intracranial cysts containing an ectopic choroid plexus or choroid plexus-like tissue have seldom been described in the literature. However, there has been no report of a spinal intramedullary cyst containing an ectopic choroid plexus. This is the first case report in the available literature of an ectopic choroid plexus tissue in the spinal cord.
A 30-year-old man presented with complaints of progressive descending weakness of both upper limbs and increasing stiffness of the lower limbs along with numbness of all four limbs without a history of any bowel or bladder disturbances. Examination was suggestive of a C5-T2 intramedullary lesion. Magnetic resonance imaging revealed a C6-T2 intramedullary cystic lesion along with a small anterosuperiorly placed lesion enhancing with contrast.
A C6-T2 laminotomy and exploration of the intramedullary cyst and gross total microsurgical excision of the reddish vascular frond-like structure resembling the choroid plexus were performed along with a syringostomy. A laminoplasty with miniplates and screws was performed. Histopathological and immunohistochemical studies revealed a normal choroid plexus. The patient has been followed for 1 year and has demonstrated symptomatic improvement.
Although there have been rare case reports of drop metastasis of choroid plexus papillomas in the spine, this is the first case report in the available literature of normal but ectopic choroid plexus tissue in the spinal cord.
颅内含有异位脉络丛或脉络丛样组织的囊肿在文献中鲜有描述。然而,尚无脊髓髓内囊肿含有异位脉络丛的报道。这是现有文献中首例关于脊髓内异位脉络丛组织的病例报告。
一名30岁男性,主诉双上肢进行性下行性无力、下肢僵硬加重以及四肢麻木,无任何肠道或膀胱功能障碍病史。检查提示C5 - T2节段髓内病变。磁共振成像显示C6 - T2节段髓内囊性病变,以及一个位于前上方的小病变,增强扫描有强化。
进行了C6 - T2椎板切开术,探查髓内囊肿,并对类似脉络丛的红色血管叶状结构进行大体全切显微手术切除,同时行脊髓空洞造瘘术。采用微型钢板和螺钉进行了椎板成形术。组织病理学和免疫组织化学研究显示为正常脉络丛。对该患者进行了1年的随访,其症状有改善。
尽管有罕见的脉络丛乳头状瘤脊柱播散转移的病例报告,但这是现有文献中首例关于脊髓内正常但异位的脉络丛组织的病例报告。