Yoshida Yuya, Tsukada Toshiyuki, Hashimoto Masaaki, Hayashi Yutaka
Department of Neurosurgery, Noto General Hospital, Nanao-city, Ishikawa, Japan.
No Shinkei Geka. 2011 Sep;39(9):865-9.
We report a case of pilocytic astrocytoma of the cerebrum presenting in an elderly patient. A 76-year-old man was admitted to our department due to the development of dysarthria. MRI showed a cystic mass with an enhanced small mural nodule in the left frontal lobe. At surgery, the cyst contents were aspirated, and the mural nodule was excised. Histological examination showed a pattern that is usually seen in pilocytic astrocytoma of the cerebellum, including loose and compact areas composed of pilocytic and stellate cells, a few eosinophilic granular bodies, but not Rosenthal fibers. Pilocytic astrocytoma is a common type of pediatric brain tumor that can arise within either the cerebellum or the hypothalamic/chiasmatic region, but rarely seen in the cerebral hemisphere at an advanced age. To our knowledge, only 45 cases of pilocytic astrocytoma of the cerebrum developing in an adult are reported. In those cases, the symptoms of the disease developed during the third decade of life. The onset at a most advanced age as in the present case is thought to be extremely rare.
我们报告一例老年患者发生的大脑毛细胞型星形细胞瘤。一名76岁男性因构音障碍而入住我科。磁共振成像(MRI)显示左额叶有一个囊性肿块,伴有一个强化的小壁结节。手术时,吸出囊内容物,并切除壁结节。组织学检查显示出一种通常在小脑毛细胞型星形细胞瘤中见到的模式,包括由毛细胞和星状细胞组成的疏松和致密区域、一些嗜酸性颗粒小体,但没有Rosenthal纤维。毛细胞型星形细胞瘤是儿童常见的脑肿瘤类型,可发生于小脑或下丘脑/视交叉区域,但在高龄时很少见于大脑半球。据我们所知,仅报道了45例成人发生的大脑毛细胞型星形细胞瘤。在这些病例中,疾病症状出现在生命的第三个十年。像本病例这样在极高龄发病被认为极为罕见。