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伴有胶质纤维酸性蛋白表达的脑室内横纹肌样乳头状脑膜瘤的弥漫性颅脊髓转移:一例报告

Diffuse craniospinal metastases of intraventricular rhabdoid papillary meningioma with glial fibrillary acidic protein expression: a case report.

作者信息

Eom Ki Seong, Kim Dae Won, Kim Tae Young

机构信息

Department of Neurosurgery, Wonkwang University School of Medicine, Iksan 570-749, Republic of Korea.

出版信息

Clin Neurol Neurosurg. 2009 Sep;111(7):619-23. doi: 10.1016/j.clineuro.2009.05.002. Epub 2009 May 30.

Abstract

Rhabdoid papillary meningioma is a recently described clinically aggressive variant of meningiomas with a high recurrence rate. Additionally, only one case of intraventricular rhabdoid meningioma has been reported so far. We present a case of a 50-year-old man who developed an intracranial tumor of the left lateral ventricle at the trigone, for which he underwent total tumor resection followed by gamma knife radiosurgery for recurrence of the tumor. The histological diagnosis was rhabdoid papillary meningioma. Five years after surgery, diffuse craniospinal leptomeningeal metastases developed and subtotal removal of the spinal tumor was performed. The spinal tumor was considered to have metastasized via cerebrospinal fluid (CSF) in view of its histological features that were identical to those of the primary tumor. Immunohistochemistry revealed the unusual cytoplasmic expression of glial fibrillary acidic protein (GFAP) of tumor cells. To our knowledge, this is the first reported case of diffuse craniospinal metastases of intraventricular rhabdoid papillary meningioma with GFAP expression and the second reported case of the rhabdoid subtype amongst intraventricular meningiomas.

摘要

横纹肌样乳头状脑膜瘤是一种最近被描述的具有高复发率的临床侵袭性脑膜瘤变体。此外,迄今为止仅报道过一例脑室内横纹肌样脑膜瘤。我们报告一例50岁男性,其在左侧脑室三角区发生颅内肿瘤,为此他接受了肿瘤全切术,术后肿瘤复发又接受了伽玛刀放射外科治疗。组织学诊断为横纹肌样乳头状脑膜瘤。术后五年,发生了弥漫性颅脊髓软脑膜转移,并对脊髓肿瘤进行了次全切除。鉴于脊髓肿瘤的组织学特征与原发肿瘤相同,考虑其是通过脑脊液(CSF)转移的。免疫组织化学显示肿瘤细胞的胶质纤维酸性蛋白(GFAP)有异常的胞质表达。据我们所知,这是首例报道的具有GFAP表达的脑室内横纹肌样乳头状脑膜瘤弥漫性颅脊髓转移病例,也是脑室内脑膜瘤中横纹肌样亚型的第二例报道病例。

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