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经远外侧经髁入路显微手术切除颅颈神经肠囊肿:病例报告及文献复习

Microsurgical excision of the craniocervical neurenteric cysts by the far-lateral transcondylar approach: case report and review of the literature.

作者信息

Shi Wei, Cui Da-Ming, Shi Jin-Long, Gu Zhi-Kai, Ju Shao-Qing, Chen Jian

出版信息

Skull Base. 2010 Nov;20(6):435-42. doi: 10.1055/s-0030-1265823.

Abstract

Neurenteric cysts in the anterior craniocervical junction (CCJ) region can be found in extremely rare cases. We report one case with craniocervical neurenteric cyst that was excised by the far-lateral transcondylar (FLT) approach. A 43-year-old man presented with a history of recurrent episodes of mild neck pain and dysesthesia in his bilateral hands of 2 years' duration with rapid deterioration 3 weeks prior to admission. Magnetic resonance imaging (MRI) of the CCJ region revealed a well-defined intradural cystic lesion located ventral from the pontomedullary junction to C1 vertebra with medulla and C1 cord compression. This patient underwent total excision of the lesion via the FLT approach without any postoperative neurological deficits, and the histopathologic diagnosis was neurenteric cyst. Follow-up MRI has revealed no evidence of recurrence. The clinical features, imaging studies, and surgical approach options involved in resecting craniocervical neurenteric cysts are discussed, along with a review of the literature.

摘要

前颅颈交界区(CCJ)的神经肠囊肿极为罕见。我们报告一例经远外侧经髁(FLT)入路切除的颅颈神经肠囊肿病例。一名43岁男性,有2年反复轻度颈部疼痛及双手感觉异常病史,入院前3周病情迅速恶化。CCJ区磁共振成像(MRI)显示一个边界清晰的硬膜内囊性病变,位于脑桥延髓交界处至C1椎体腹侧,压迫延髓和C1脊髓。该患者经FLT入路行病变全切术,术后无任何神经功能缺损,组织病理学诊断为神经肠囊肿。随访MRI未发现复发迹象。本文讨论了颅颈神经肠囊肿的临床特征、影像学检查及手术切除方法,并复习了相关文献。

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本文引用的文献

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Intraspinal neurenteric cysts in children.儿童脊髓内肠源性囊肿
Can J Neurol Sci. 2008 Nov;35(5):609-15. doi: 10.1017/s0317167100009409.
2
Mucinous low-grade adenocarcinoma arising in an intracranial enterogenous cyst: case report.
Neurosurgery. 2008 Apr;62(4):E972-3; discussion E973. doi: 10.1227/01.neu.0000318186.10536.f6.
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Neurenteric cyst of the craniocervical junction in an infant.婴儿颅颈交界区的神经管囊肿
Neurol Med Chir (Tokyo). 2008 Feb;48(2):86-9. doi: 10.2176/nmc.48.86.
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Far-lateral approach to the craniocervical junction.颅颈交界区的远外侧入路
Neurosurgery. 2005 Oct;57(4 Suppl):367-71; discussion 367-71. doi: 10.1227/01.neu.0000176848.05925.80.
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Spinal neurenteric cyst. Report of 4 cases and review of the literature.
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Ventral brainstem enterogenous cyst: an unusual location.腹侧脑干肠源性囊肿:一个不寻常的部位。
Acta Neurochir (Wien). 2004 Apr;146(4):419-20; discussion 420. doi: 10.1007/s00701-004-0227-2. Epub 2004 Feb 25.

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