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孟氏孔孤立性纤维瘤

Solitary fibrous tumor of the foramen of Monro.

作者信息

Kinfe Thomas M, Tschan Christoph A, Stan Alexandru C, Krauss Joachim K

机构信息

Department of Neurosurgery, Medical School Hannover, MHH, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.

出版信息

Clin Neurol Neurosurg. 2008 Apr;110(4):404-7. doi: 10.1016/j.clineuro.2007.12.015. Epub 2008 Feb 20.

Abstract

Solitary fibrous tumors have been described rarely in the central nervous system and only exceptionally within the ventricular system. This benign entity shows histoimmunochemically strong positivity for vimentin and calretinin. Little is known about the pathophysiological aspects. The authors report on a 75-year-old woman who presented with clinical signs of occlusive hydrocephalus including cognitive deficits, urine incontinence and gait disturbance. Imaging studies demonstrated a tumor at the foramen of Monro which was thought to be a colloid cyst and she underwent CSF shunting. After recurrent episodes of shunt dysfunction the tumor was removed via a transventricular approach guided by endoscopic ventriculoscopy. The histopathological examination revealed a solitary fibrous tumor. This is the first report on a solitary fibrous tumor located at the foramen of Monro in an elderly patient. Surgical removal has been considered to be the best therapeutic strategy in treating this rare entity with no need of postoperative adjuvant therapy. Further imaging and histological studies are needed to improve understanding of the pathophysiological aspects behind it.

摘要

孤立性纤维瘤在中枢神经系统中鲜有报道,在脑室系统中更是罕见。这种良性病变在组织免疫化学上对波形蛋白和钙结合蛋白呈强阳性。关于其病理生理学方面知之甚少。作者报告了一名75岁女性,她出现了梗阻性脑积水的临床症状,包括认知缺陷、尿失禁和步态障碍。影像学研究显示在孟氏孔处有一个肿瘤,最初被认为是一个胶样囊肿,她接受了脑脊液分流术。在分流功能反复出现障碍后,通过内镜脑室镜引导下的经脑室入路切除了肿瘤。组织病理学检查显示为孤立性纤维瘤。这是首例关于老年患者孟氏孔处孤立性纤维瘤的报道。手术切除被认为是治疗这种罕见病变的最佳治疗策略,无需术后辅助治疗。需要进一步的影像学和组织学研究来加深对其背后病理生理学方面的理解。

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