Park Jung Eon, Park Myong Chul, Yoon Soo Han, Kim Jang Hee
Department of Neurosurgery, Ajou University School of Medicine, Suwon, South Korea.
Pediatr Neurosurg. 2008;44(4):318-23. doi: 10.1159/000134924. Epub 2008 May 27.
Intracranial extracerebral neuroglial choristoma is a very rare entity. A cleft palate or a nasopharyngeal teratoma has been described as accompanying choristoma, but there are no observations of both anomalies being simultaneously present and combined.
An 8-month-old girl presented with seizures, without evidence of any other neurological abnormalities. Brain magnetic resonance imaging demonstrated a 2.0-cm-sized, round-shaped mass in the frontal midline. The T(1)- and T(2)-weighted images showed a well-circumscribed iso-signal intensity lesion with no gadolinium enhancement.
Surgical exploration revealed a yellowish tumor mass with whitish soft tissue material within the tumor, adherence to the surrounding blood vessels, and therefore subtotal removal was performed. Pathologic examination was neuroglial choristoma with 1.5% of MIB-1 labeling index. The patient also had a cleft palate with a pinkish palatal mass and underwent repair of the cleft palate, and excision of mass that was a mature cystic teratoma on pathologic examination. Follow-up at 18 months later showed that there was no evidence of tumor regrowth or neurological deficit, and the neurological development was normal.
The authors described a rare case of intracranial extracerebral neuroglial choristoma accompanied by both nasopharyngeal teratoma and cleft palate and suggested its benign nature from the low MIB-1 labeling index.
颅内脑外神经胶质迷离瘤是一种非常罕见的疾病。腭裂或鼻咽部畸胎瘤曾被描述为与迷离瘤伴发,但尚无二者同时存在并合并的观察报道。
一名8个月大的女孩出现癫痫发作,无任何其他神经功能异常的证据。脑部磁共振成像显示额中线有一个2.0厘米大小的圆形肿块。T1加权和T2加权图像显示一个边界清晰的等信号强度病变,无钆增强。
手术探查发现一个淡黄色肿瘤肿块,肿瘤内有白色软组织物质,与周围血管粘连,因此进行了次全切除。病理检查为神经胶质迷离瘤,MIB-1标记指数为1.5%。该患者还患有腭裂,伴有粉红色腭部肿块,并接受了腭裂修复术以及对病理检查为成熟囊性畸胎瘤的肿块切除术。18个月后的随访显示,没有肿瘤复发或神经功能缺损的证据,神经发育正常。
作者描述了一例罕见的颅内脑外神经胶质迷离瘤伴鼻咽部畸胎瘤和腭裂的病例,并根据低MIB-1标记指数提示其良性性质。