间变性少突胶质细胞瘤继发软脑膜播散所致急性脑积水
Acute Hydrocephalus due to Secondary Leptomeningeal Dissemination of an Anaplastic Oligodendroglioma.
作者信息
Stark Andreas M, Hugo Heinz-Herrmann, Mehdorn H Maximilian, Knerlich-Lukoschus Friederike
机构信息
Department of Neurosurgery, Schleswig-Holstein University Medical Center, Campus Kiel, Arnold-Heller-Str. 3, 24105 Kiel, Germany.
出版信息
Case Rep Med. 2009;2009:370901. doi: 10.1155/2009/370901. Epub 2009 Dec 20.
Secondary leptomeningeal dissemination of oligodendroglioma is very rare. We report the case of a 38-year-old Caucasian male who presented with acute hydrocephalus. 8 months before, the patient had undergone craniotomy for right frontal anaplastic oligodendroglioma, WHO grade III. By that time, there was no evidence of tumor dissemination. MRI now ruled out local tumor progression but revealed meningeal contrast enhancement along the medulla, the myelon, and the cauda equina. Repeated lumbar puncture revealed increased cerebro-spinal fluid (CSF) pressure and protein content. Malignant cells were not detectable. Surgical treatment consisted in (1) placement of an ommaya reservoir for daily CSF puncture, (2) Spinal dural biopsy confirming leptomeningeal oligodendroglioma metastasis, and (3) ventriculo-peritoneal shunt placement after CSF protein has decreased to 1500-2000 mg/l.
少突胶质细胞瘤的继发性软脑膜播散非常罕见。我们报告一例38岁的白种男性患者，其表现为急性脑积水。8个月前，该患者因右额叶间变性少突胶质细胞瘤（WHO III级）接受了开颅手术。当时，没有肿瘤播散的证据。目前的磁共振成像（MRI）排除了局部肿瘤进展，但显示延髓、脊髓和马尾有脑膜强化。反复腰椎穿刺显示脑脊液（CSF）压力和蛋白质含量升高。未检测到恶性细胞。手术治疗包括：（1）放置Ommaya储液器以便每日进行脑脊液穿刺；（2）脊髓硬脊膜活检证实软脑膜少突胶质细胞瘤转移；（3）在脑脊液蛋白降至1500 - 2000mg/l后进行脑室-腹腔分流术。
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