Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan.
Brain Tumor Pathol. 2011 Oct;28(4):371-4. doi: 10.1007/s10014-011-0042-4. Epub 2011 Jun 4.
Intracranial endodermal cysts presenting with hemifacial spasm (HFS) are extremely rare. We report a right cerebellopontine angle (CPA) endodermal cyst in a 56-year-old man who presented with a 6-month history of right-sided hemifacial spasm. Computed tomography revealed a homogenous, well-demarcated, hyperdense lesion extending from prepontine cistern to right CPA. Magnetic resonance imaging demonstrated a right CPA extra-axial cystic lesion protruding into Meckel's cave, with compression of cranial nerves VII and VIII. Light brown, creamy cystic content was totally removed, and the thin cyst wall surrounding cranial nerves VII and VIII and the right vertebral artery was subtotally removed through the right lateral suboccipital approach. On microscopic examination, the cyst wall was composed of mono- to multilayered stratified epithelia, which were lined by ciliated or nonciliated cuboidal cells, with cilia showing the characteristic 9 + 2 pattern. Immunohistochemistry showed positive staining of cells composing the cyst wall with carcinoembryonic antigen, epithelial membrane antigen, cytokeratin 8, and negative staining with cytokeratin 20, and S-100, thereby characterizing endodermal cyst. Postoperatively, the patient was free of facial spasm.
颅内肠源性囊肿伴面肌痉挛（HFS）极为罕见。我们报告一例 56 岁男性右桥小脑角（CPA）肠源性囊肿，表现为右侧面肌痉挛 6 个月。计算机断层扫描显示起源于桥前池延伸至右 CPA 的均质、边界清楚的高密度病变。磁共振成像显示右 CPA 外轴囊性病变突入 Meckel 腔，压迫颅神经 VII 和 VIII。浅棕色奶油状囊性内容物被完全切除，通过右侧枕下入路部分切除了包裹颅神经 VII 和 VIII 以及椎动脉的薄的囊肿壁。显微镜下观察，囊肿壁由单层至多层复层上皮组成，由纤毛或无纤毛的立方细胞衬里，纤毛显示特征性的 9+2 模式。免疫组织化学显示囊肿壁细胞的癌胚抗原、上皮膜抗原、细胞角蛋白 8 阳性，细胞角蛋白 20 和 S-100 阴性，从而确定为肠源性囊肿。术后，患者面肌痉挛消失。
