Department of Neurosurgery, The First Hospital of Jilin University, Changchun, PR China.
World J Surg Oncol. 2011 Mar 23;9:36. doi: 10.1186/1477-7819-9-36.
Cavernous malformations (CMs) in the cerebellopontine angle (CPA) are rare, and most of such CMs reported to date are solid and extend from the internal auditory canal into the CPA. In contrast, cystic CMs that arise in the CPA and do not involve the internal auditory canal and dura of the skull base are extremely rare.
A 50-year-old man presented with vertigo and progressive hearing loss in the right ear. MRI examination revealed a lesion in the CPA with solid and cystic components. Surgery was performed. Well-circumscribed adhesion to cranial nerves, the cerebellum, or the brain stem was noted during surgery. The lesion was totally resected. Pathological examination suggested the lesion to be a CM. At 1-year follow-up, the symptoms at presentation had resolved and no complications had occurred.
Although cystic CMs of the CPA have no established imaging features, a diagnosis of CMs may be suspected when a cystic lesion is present in the CPA and does not involve internal acoustic meatus or dura mater of the skull base. Skillful microsurgical techniques and monitoring of cranial nerves will secure good outcomes for patients with cystic CMs in the CPA.
桥小脑角(CPA)的海绵状血管畸形(CMs)很少见,迄今为止报告的大多数此类 CMs 为实性,从内耳道延伸至 CPA。相比之下,CPA 内出现且不涉及内听道和颅底硬脑膜的囊性 CMs 极为罕见。
一名 50 岁男性因眩晕和右侧耳渐进性听力丧失就诊。MRI 检查显示 CPA 有实性和囊性成分的病变。行手术治疗。术中发现病变与颅神经、小脑或脑干界限清楚地粘连。病变完全切除。病理检查提示病变为 CM。随访 1 年,患者的症状已缓解,无并发症发生。
尽管 CPA 的囊性 CMs 没有明确的影像学特征,但当 CPA 内存在囊性病变且不涉及内听道或颅底硬脑膜时,可能怀疑为 CMs。熟练的显微手术技术和颅神经监测将为 CPA 内囊性 CMs 患者带来良好的预后。