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与神经纤维瘤病相关的脑膜血管外皮细胞瘤:一个家族中的2例报告及文献复习

Meningioangiomatosis associated with neurofibromatosis: report of 2 cases in a single family and review of the literature.

作者信息

Omeis Ibrahim, Hillard Virany Huynh, Braun Alex, Benzil Deborah L, Murali Raj, Harter David H

机构信息

Department of Neurosurgery, New York Medical College, Valhalla, NY 10595, USA.

出版信息

Surg Neurol. 2006 Jun;65(6):595-603. doi: 10.1016/j.surneu.2005.09.034.

Abstract

BACKGROUND

Meningioangiomatosis (MA) is a rare benign disorder. It may occur sporadically or in association with neurofibromatosis (NF). The sporadic type typically presents with seizures, whereas that associated with NF is often asymptomatic. Of the 100 cases reported, only 14 are associated with NF. We now report 2 additional cases of MA associated with neurofibromatosis 2 (NF2) in a single family, with one occurring in the cerebellum. The etiology, pathology, and imaging features of MA are presented.

CASE DESCRIPTION

A 38-year-old woman (patient 1) presented with a 4-month history of ataxia. She had been diagnosed previously with NF2. Magnetic resonance imaging (MRI) scans of the brain revealed bilateral acoustic neuromas and multiple calcified intracranial lesions. Her 13-year-old daughter (patient 2) presented with complex partial seizures. MRI scans of the brain revealed bilateral acoustic neuromas and a right parietal mass. Patient 1 underwent a suboccipital craniotomy to resect the right-sided acoustic neuroma. A small portion of normal-appearing cerebellar cortex was resected to avoid undue retraction. Histopathologic examination showed the presence of a lesion consistent with MA. Patient 2 underwent a right temporal-parietal craniotomy to remove the enhancing epileptogenic right posterior temporoparietal lesion. Histopathologic analysis showed a lesion consistent with meningioma and MA.

CONCLUSIONS

MA has been reported infrequently in association with NF2. We now report 2 cases of MA associated with NF2 in one family, and we add the cerebellum to possible locations of occurrence. MA should be considered in the differential diagnosis of cortical lesions, particularly in patients with NF2.

摘要

背景

脑膜血管外皮细胞瘤(MA)是一种罕见的良性疾病。它可能散发性发生,也可能与神经纤维瘤病(NF)相关。散发性类型通常表现为癫痫发作,而与NF相关的类型通常无症状。在已报道的100例病例中,只有14例与NF相关。我们现报告在一个家族中另外2例与神经纤维瘤病2型(NF2)相关的MA病例,其中1例发生在小脑。本文介绍了MA的病因、病理及影像学特征。

病例描述

一名38岁女性(患者1)有4个月的共济失调病史。她之前被诊断为NF2。脑部磁共振成像(MRI)扫描显示双侧听神经瘤和多个颅内钙化病变。她13岁的女儿(患者2)表现为复杂部分性癫痫发作。脑部MRI扫描显示双侧听神经瘤和右侧顶叶肿块。患者1接受了枕下开颅手术以切除右侧听神经瘤。为避免过度牵拉,切除了一小部分外观正常的小脑皮质。组织病理学检查显示存在一个与MA相符的病变。患者2接受了右侧颞顶叶开颅手术,以切除右侧颞顶叶后部强化的致痫病变。组织病理学分析显示一个与脑膜瘤和MA相符的病变。

结论

MA与NF2相关的报道较少。我们现报告一个家族中2例与NF2相关的MA病例,并将小脑添加到可能的发病部位中。在皮质病变的鉴别诊断中应考虑MA,尤其是在NF2患者中。

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