Mirone G, Schiabello L, Chibbaro S, Bouazza S, George B
Department of Neurosurgery, Lariboisiere University Hospital, Paris, France.
Childs Nerv Syst. 2009 Feb;25(2):247-51. doi: 10.1007/s00381-008-0690-9. Epub 2008 Aug 9.
We describe a rare case of pediatric pilocytic astrocytoma presented as a right cerebellopontine angle (CPA) mass, completely separated from the brain stem and arising from the proximal VIII nerve portion.
A 12-year-old boy, with no evidence of neurofibromatosis type 2, presented with progressive hearing loss at the right ear and headache. An initial enhanced magnetic resonance examination suggested the diagnosis of schwannoma. The tumor was resected by a suboccipital retrosigmoid approach.
Our case seems to be the first report of a primary pediatric CPA pylocitic astrocytoma arising from the VIII nerve complex and presenting internal auditory canal enlargement. It represents the third reported case of a primary CPA pilocytic astrocytoma (the second pediatric case with the first arising from V nerve) and the eighth report of primary CPA glioma, overall. We discuss the clinical, neuroradiological, and intraoperative findings, and we review the different hypothesis about the origin of these rare tumors.
我们描述了一例罕见的小儿毛细胞型星形细胞瘤,表现为右侧桥小脑角(CPA)肿块,与脑干完全分离,起源于第八对脑神经近端。
一名12岁男孩,无2型神经纤维瘤病证据,出现右耳进行性听力丧失和头痛。最初的增强磁共振检查提示为神经鞘瘤诊断。通过枕下乙状窦后入路切除肿瘤。
我们的病例似乎是首例起源于第八对脑神经复合体并伴有内耳道扩大的原发性小儿CPA毛细胞型星形细胞瘤报告。总体而言,它是第三例报告的原发性CPA毛细胞型星形细胞瘤(第二例小儿病例,第一例起源于第五对脑神经)以及第八例原发性CPA胶质瘤报告。我们讨论了临床、神经放射学和术中发现,并回顾了关于这些罕见肿瘤起源的不同假说。