Ohshima Tomotaka, Ogura Koichiro, Nakayashiki Norihisa, Tachibana Eiji
Department of Neurosurgery, Kamo Hospital, Toyota 471-0024, Japan.
Surg Neurol. 2005 Sep;64(3):266-9; discussion 269. doi: 10.1016/j.surneu.2004.11.035.
An intracranial lesion of intravascular papillary endothelial hyperplasia (IPEH) is extremely rare and often difficult to resect completely. We describe a case in which a lesion at the superior orbital fissure was successfully treated by postoperative radiosurgery.
A 41-year-old woman presented with progressive left abducens nerve paresis and left facial sensory disturbance over a 1-year period. Radiological examination demonstrated a left middle fossa tumor involved in the cavernous sinus. About a half removal of the tumor was performed. The pathological diagnosis was IPEH. The residual tumor was treated with gamma knife radiosurgery.
Gamma knife radiosurgery was effective to reduce the residual tumor in the present case. During a follow-up period of 2 years, the lesion has not recurred. This report suggests that additional gamma knife radiosurgery after incomplete resection of the lesion could be an alternative therapeutic modality.
颅内血管内乳头状内皮增生(IPEH)极为罕见,且往往难以完全切除。我们描述了一例经术后放射外科成功治疗的眶上裂病变病例。
一名41岁女性在1年时间里出现进行性左侧展神经麻痹和左侧面部感觉障碍。影像学检查显示左侧中颅窝肿瘤累及海绵窦。肿瘤大约切除了一半。病理诊断为IPEH。残余肿瘤采用伽玛刀放射外科治疗。
在本病例中,伽玛刀放射外科有效地缩小了残余肿瘤。在2年的随访期内,病变未复发。本报告表明,病变不完全切除后追加伽玛刀放射外科可能是一种替代治疗方式。