Keiner D, Gaab M R, Ostertag H, Sommer C, Oertel J
Department of Neurosurgery, Johannes-Gutenberg-University, Mainz, Germany.
Minim Invasive Neurosurg. 2009 Oct;52(5-6):242-5. doi: 10.1055/s-0029-1239502. Epub 2010 Jan 14.
A 38-year-old man with a right frontal lobe cyst was treated by endoscopic cystoventriculostomy in 1998. Cyst capsule histology revealed surprisingly an endodermal cyst. The patient was reoperated for cyst expansion by endoscopic re-cystoventriculostomy in 2005. In 2007, the patient suffered from brain abscess formation within the cyst which was punctured. The history was positive for a dental infection. In 2008, a recurrent brain abscess in the cyst occurred. The cyst was completely resected. There was no history of trauma or sinusitis. In all, endodermal cysts may mimic a paraxial arachnoid cyst. It may predispose for recurrent brain abscess formation - especially due to bacteraemia. This report confirms earlier presentations that endodermal cysts should be resected, and endoscopic cyst opening is not sufficient.
一名38岁的男性,患有右侧额叶囊肿,于1998年接受了内镜下囊肿脑室造瘘术治疗。囊肿包膜组织学检查令人惊讶地发现是一个内胚层囊肿。该患者于2005年因囊肿扩大再次接受手术,行内镜下再次囊肿脑室造瘘术。2007年,患者囊肿内形成脑脓肿并进行了穿刺。病史显示有牙齿感染。2008年,囊肿内再次发生脑脓肿。囊肿被完全切除。患者无外伤或鼻窦炎病史。总之,内胚层囊肿可能类似于近轴蛛网膜囊肿。它可能易引发复发性脑脓肿形成——尤其是由于菌血症。本报告证实了早期的观点,即内胚层囊肿应行切除术,单纯内镜下囊肿开窗术并不足够。