Jeong In-Ho, Lee Jung-Kil, Moon Kyung-Sub, Joo Sung-Pil, Kwak Hyung-Jun, Kim Tae-Sun, Kim Jae-Hyoo, Kim Soo-Han
Department of Neurosurgery, Chonnam National University Hospital & Medical School, Dong-ku, Gwangju, South Korea.
J Neurooncol. 2006 Sep;79(2):191-5. doi: 10.1007/s11060-006-9124-2. Epub 2006 Jul 19.
The ectopic recurrence of craniopharyngioma is a rare postoperative complication, for which there are fifteen reported cases that have been surgically verified. The authors present a rare case of ectopic recurrence along the tract of the surgical route. A 12-year-old girl, who had undergone total removal of a suprasellar craniopharyngioma 4 years previously, presented with a generalized tonic-clonic seizure. Magnetic resonance imaging revealed a strongly enhancing cystic tumor in the right frontal lobe, under the bone flap used for the previous craniotomy. Gross total resection was achieved by revision of previous craniotomy. The intraoperative findings revealed that the recurrent tumor was anatomically related to the previous surgical tract, suggesting dissemination along the operative tract. The histopathological features of the mass were the same as those of the previous suprasellar craniopharyngioma. The case presented here and a review of the reports on the previous instances of ectopic recurrence of craniopharyngioma suggest that meticulous protection of the surgical field and careful handling of the tumor during the operation are required. It should be emphasized that long-term follow-up is mandatory, even in patients who underwent a gross total removal.
颅咽管瘤的异位复发是一种罕见的术后并发症，目前有15例经手术证实的报道病例。作者报告了1例沿手术路径出现异位复发的罕见病例。一名12岁女孩，4年前接受了鞍上颅咽管瘤全切术，现出现全身强直阵挛发作。磁共振成像显示，在先前开颅手术使用的骨瓣下方的右侧额叶有一个强化明显的囊性肿瘤。通过再次开颅手术实现了肿瘤全切。术中发现复发肿瘤在解剖学上与先前的手术路径相关，提示肿瘤沿手术路径播散。该肿物的组织病理学特征与先前鞍上颅咽管瘤相同。本文报道的病例以及对先前颅咽管瘤异位复发病例报告的回顾表明，手术中需要精心保护术野并小心处理肿瘤。应当强调的是，即使是接受了肿瘤全切的患者，也必须进行长期随访。
