Arishima H, Sindou M
Department of Neurosurgery, Hôpital Neurologique Pierre Wertheimer, Lyon, France.
Minim Invasive Neurosurg. 2010 Aug;53(4):194-7. doi: 10.1055/s-0030-1263114. Epub 2010 Dec 3.
Case 1, a 61-year-old female presented with paresthesia of her right upper lip. Computed tomography (CT) and magnetic resonance (MR) imaging with contrast material revealed an enhanced mass in the right Meckel's cave, which included the lateral and posterior parts of the cavernous sinus and surrounded the right internal carotid artery. To establish the best surgical strategy, a percutaneous biopsy through the foramen ovale was performed, and the histological examination indicated that the tumor was a transitional meningioma. We performed combined treatment with microsurgery and radiosurgery. Case 2,a 66-year-old female presented with paresthesia of the right side of her face. MR images with gadolinium revealed an abnormal enhanced mass at the right Meckel's cave, and a CT scan with a bone window showed a large foramen ovale in the right side. We performed a percutaneous biopsy using the same method, but this tumor was too hard to sample through the needle. Although this manipulation has the major advantage of establishing the best therapeutic strategy and avoiding unnecessary surgery, special care should be taken for hard tumors, especially for those aspirated by needle biopsy.
病例1，一名61岁女性，表现为右上唇感觉异常。计算机断层扫描（CT）和增强磁共振成像（MR）显示右侧梅克尔腔有一强化肿块，该肿块累及海绵窦外侧和后部，并包绕右侧颈内动脉。为制定最佳手术策略，经卵圆孔进行了经皮活检，组织学检查表明该肿瘤为过渡型脑膜瘤。我们采用显微手术和放射外科联合治疗。病例2，一名66岁女性，表现为右侧面部感觉异常。钆增强MR图像显示右侧梅克尔腔有一异常强化肿块，骨窗CT扫描显示右侧卵圆孔增大。我们采用相同方法进行了经皮活检，但该肿瘤质地过硬，难以通过针吸取样。尽管这种操作具有确定最佳治疗策略和避免不必要手术的主要优势，但对于质地坚硬的肿瘤，尤其是通过针吸活检取材的肿瘤，应格外小心。
