J Neurooncol. 2012 Jan;106(2):431-5. doi: 10.1007/s11060-011-0678-2. Epub 2011 Aug 12.
We observed a patient with subcutaneous seeding from gliomatosis cerebri with a low-grade histopathology. A 33-year-old woman with neurofibromatosis type 1 presented with progressive headache, diplopia, dysphagia, and a rightward instability. On neurological examination dysarthria, gait ataxia, and left-sided central facial and hypoglossal palsies were determined. MRI of the brain demonstrated diffuse, infiltrative non-enhancing lesions in the pons, both cerebellar hemispheres, the parahippocampal gyrus, and the thalamus. A stereotactic biopsy demonstrated an astrocytoma WHO grade 2. These characteristics confirmed gliomatosis cerebri. Three months later, the patient presented with hydrocephalus and a subcutaneous swelling directly underneath the surgical scar. The subcutaneous swelling was removed and the hydrocephalus was treated by ventriculoperitoneal shunting. Histopathological examination confirmed a subcutaneous manifestation of low-grade oligoastrocytoma. Gliomatosis cerebri with low-grade histology can seed subcutaneously.
我们观察到一名脑胶质瘤伴低度组织病理学的皮下播散患者。一名 33 岁的女性患有 1 型神经纤维瘤病，表现为进行性头痛、复视、吞咽困难和向右不稳定。神经系统检查发现构音障碍、步态共济失调和左侧中枢性面瘫和舌下神经麻痹。脑部 MRI 显示桥脑、双侧小脑半球、海马旁回和丘脑有弥漫性浸润性非增强病变。立体定向活检显示为星形细胞瘤 WHO 2 级。这些特征证实了脑胶质瘤的存在。三个月后，患者出现脑积水和手术疤痕下直接的皮下肿胀。皮下肿胀被切除，脑积水通过脑室-腹腔分流术进行治疗。组织病理学检查证实为低度少突星形细胞瘤的皮下表现。低度组织学的脑胶质瘤可以向皮下播散。
