Romani Rossana, Niemelä Mika, Korja Miikka, Hernesniemi Juha A
Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland.
Neurosurgery. 2008 Nov;63(5):E1003; discussion E1003. doi: 10.1227/01.NEU.0000330388.91098.89.
Colloid cysts of the third ventricle are rare benign tumors of endodermal origin accounting for 1% of all intracranial tumors. Interestingly, a few familial cases have been reported previously. We present the first case of dizygotic twins with a symptomatic colloid cyst of the third ventricle.
A 10-year-old boy was admitted to a local hospital in 1993 because of severe progressive headache. Computed tomographic and magnetic resonance imaging scans revealed acute obstructive hydrocephalus attributable to a third ventricular colloid cyst, which was removed after emergent ventricular drainage. Fourteen years later, a nonidentical twin brother complained of continuous headache with nausea and vomiting. A magnetic resonance imaging scan showed obstructive hydrocephalus and a third ventricle colloid cyst, which was removed by use of the transcallosal approach.
Both twins underwent complete removal of the cyst by the interhemispheric transcallosal approach without postoperative complications.
On the basis of a literature review, 2 cases of colloid cysts of the third ventricle in monozygotic twins and a few familial cases have been reported. Our case is the first in dizygotic twin brothers. These findings suggest that the prevalence of colloid cyst may be higher in twins than in the general population. We believe that the presence of this lesion in a twin necessitates magnetic resonance imaging of the other twin, and a clinical follow-up would be recommended in all other first-degree relatives.
第三脑室胶样囊肿是罕见的起源于内胚层的良性肿瘤,占所有颅内肿瘤的1%。有趣的是,此前已有少数家族性病例报道。我们报告首例患有症状性第三脑室胶样囊肿的异卵双胞胎病例。
一名10岁男孩于1993年因严重进行性头痛入住当地医院。计算机断层扫描和磁共振成像扫描显示,急性梗阻性脑积水归因于第三脑室胶样囊肿,在紧急脑室引流后囊肿被切除。14年后,一名非同卵双胞胎兄弟主诉持续头痛伴恶心和呕吐。磁共振成像扫描显示梗阻性脑积水和第三脑室胶样囊肿,通过经胼胝体入路将囊肿切除。
两名双胞胎均通过经半球间胼胝体入路完全切除囊肿且无术后并发症。
根据文献综述,已报道2例单卵双胞胎患第三脑室胶样囊肿的病例以及少数家族性病例。我们的病例是首例异卵双胞胎兄弟患病。这些发现表明,双胞胎中胶样囊肿的患病率可能高于一般人群。我们认为,双胞胎中一人患有此病变,另一人有必要进行磁共振成像检查,并且建议对所有其他一级亲属进行临床随访。