Suzuki Sakiko, Wanifuchi Hiroshi, Shimizu Takashi, Kubo Osami
Department of Neurosurgery, Saiseikai Kurihashi Hospital.
Neurol Med Chir (Tokyo). 2009 Nov;49(11):520-3. doi: 10.2176/nmc.49.520.
A 31-year-old female presented with a particularly rare hemangiopericytoma (HPC) in the right lateral ventricle manifesting as a 6-month history of visual disturbance and headache. Left hemianopsia and choked disc were identified by an ophthalmologist who referred her to us. Magnetic resonance imaging demonstrated a 5-cm homogeneously enhanced mass in the trigone of the right lateral ventricle. The tumor was totally removed by two stage surgery. The histological findings were consistent with HPC. HPC is very important to differentiate from meningioma and solitary fibrous tumors because HPC is more aggressive. The histological and immunochemical findings are important for the differential diagnosis. The present case showed no local recurrence or metastasis without radiation therapy for 4 years, indicating that radiation therapy is not absolutely imperative for patients with intraventricular HPC showing low MIB-1 staining index after total removal.
一名31岁女性因右侧侧脑室出现极为罕见的血管外皮细胞瘤(HPC)就诊,其症状为视力障碍和头痛,病程6个月。眼科医生检查发现左侧偏盲和视盘水肿,并将她转诊至我院。磁共振成像显示右侧侧脑室三角区有一个5厘米大小的均匀强化肿块。该肿瘤通过两阶段手术被完全切除。组织学检查结果与HPC相符。由于HPC更具侵袭性,因此将其与脑膜瘤和孤立性纤维瘤进行鉴别非常重要。组织学和免疫化学检查结果对鉴别诊断很重要。该病例在未接受放射治疗的情况下4年未出现局部复发或转移,这表明对于全切除后MIB-1染色指数较低的脑室内HPC患者,放射治疗并非绝对必要。