Ohmori Y, Kubo S, Yasukouchi K, Takemi K, Ikeda M, Ibayashi N
Department of Neurosurgery, Kyoto 2nd Red Cross Hospital, Japan.
No Shinkei Geka. 1991 Mar;19(3):267-71.
A case of intracranial fibrous xanthoma (xanthofibroma) is reported. Intracranial fibrous xanthoma in infancy under the age of 1 year is extremely rare. This patient was a 8-month-old boy with a history of convulsive seizure. He had a previously known chest wall tumor which was diagnosed as fibrous xanthoma of the skin. Plain CT scan revealed a well defined high density area in the left temporal lobe. The area was well enhanced with contrast media. At operation, it was found that the tumor did not attach to dura mater and was almost well demarcated. Total removal of the tumor was performed. The patient has been doing well for these 6 months following craniotomy, with no sings of recurrence and no neurological deficits. Histologically, the tumor was composed of fibroblastic cells and foamy phagocytic cells in storiform pattern. Some multinucleated giant cells were found. Immunohistochemistry technique revealed that the tumor cells were negative for GFAP, positive for Vimentin, positive for S-100 protein and negative for EMA. Our studies support the diagnosis of intracranial fibrous xanthoma coexistent with the same tumor found in the subcutaneous space of the chest wall of a boy under 1 year of age. We regard it as a rare incidence. Differential diagnosis and the characteristics of fibrous xanthoma were discussed.
报告了1例颅内纤维性黄色瘤（黄色纤维瘤）。1岁以下婴儿颅内纤维性黄色瘤极为罕见。该患者为1名8个月大男童，有惊厥发作史。其曾患胸壁肿瘤，被诊断为皮肤纤维性黄色瘤。CT平扫显示左颞叶有一界限清楚的高密度区。该区域在注入造影剂后强化明显。手术中发现肿瘤未附着于硬脑膜，且界限基本清楚。遂将肿瘤完整切除。开颅术后这6个月，患者情况良好，无复发迹象及神经功能缺损。组织学检查显示，肿瘤由呈束状排列的成纤维细胞和泡沫状吞噬细胞组成。可见一些多核巨细胞。免疫组织化学技术显示，肿瘤细胞GFAP阴性、波形蛋白阳性、S-100蛋白阳性、EMA阴性。我们的研究支持1岁以下男童颅内纤维性黄色瘤与胸壁皮下相同肿瘤并存的诊断。我们认为这是一种罕见病例。文中讨论了纤维性黄色瘤的鉴别诊断及特点。
