Montibeller Guilherme Ramina, Stan Alexandru-Constantin, Krauss Joachim Kurt, Nakamura Makoto
Department of Neurosurgery, Hannover Medical School, Hannover, Germany.
Neurosurgery. 2009 Nov;65(5):E1005-6; discussion E1006. doi: 10.1227/01.NEU.0000351770.69874.15.
Quadrigeminal plate lesions are rare and usually present with a silent clinical course. Tumors, vascular lesions, inflammatory and infectious processes have been described in this region. Calcifying pseudoneoplasms, also reported as fibro-osseous lesions, cerebral calculi, and brain stones, are unusual lesions in the central nervous system. They can be revealed by cranial radiography, computed tomography, and magnetic resonance imaging as calcified masses and should be differentiated from neoplastic, inflammatory, and vascular lesions. To the best of our knowledge, the occurrence of a calcifying pseudoneoplasm located at the quadrigeminal plate has not yet been reported.
A 67-year-old woman with a 6-month history of several daily attacks of dizziness presented to our service. Magnetic resonance imaging studies revealed a tumor in the right inferior colliculus. This lesion was isointense on T1-weighted imaging, hypointense on T2-weighted imaging, and homogeneously enhanced with contrast.
The lesion at the quadrigeminal plate was completely removed, and the patient was successfully treated without any new neurological deficit. At the time of follow-up, all preoperative symptoms had resolved.
We report the first case of a calcifying pseudoneoplasm of the inferior colliculus. Complete surgical removal of this type of tumor is feasible. We propose surgical treatment in this location when this tumor becomes symptomatic.
四叠体板病变罕见,通常临床过程隐匿。该区域已报道过肿瘤、血管病变、炎症及感染性病变。钙化性假瘤,也被报道为纤维骨性病变、脑结石,是中枢神经系统中的罕见病变。它们可通过头颅X线摄影、计算机断层扫描和磁共振成像显示为钙化肿块,应与肿瘤性、炎症性和血管性病变相鉴别。据我们所知,位于四叠体板的钙化性假瘤的发生尚未见报道。
一名67岁女性,有6个月每日发作数次头晕的病史,前来我院就诊。磁共振成像检查显示右下方丘有一肿瘤。该病变在T1加权成像上呈等信号,在T2加权成像上呈低信号,增强扫描呈均匀强化。
四叠体板处的病变被完全切除,患者成功接受治疗,未出现任何新的神经功能缺损。随访时,所有术前症状均已缓解。
我们报道了首例下丘钙化性假瘤病例。完全手术切除此类肿瘤是可行的。当该肿瘤出现症状时,我们建议在此部位进行手术治疗。