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[一例成人侧脑室及小脑桥脑角同时发现的恶性脉络丛乳头状瘤病例]

[An adult case of malignant choroid plexus papilloma in the lateral ventricle and the cerebellopontine angle revealed simultaneously].

作者信息

Handa T, Hashizume Y, Mutsuga N, Takahashi I, Nishimura M

机构信息

Department of Neurosurgery, Nagoya University School of Medicine.

出版信息

No Shinkei Geka. 1990 Aug;18(8):751-6.

PMID:2215870
Abstract

An adult case of malignant choroid plexus papilloma is very rare. This report is an adult case of malignant choroid plexus papilloma revealed in the lateral ventricle and in the cerebellopontine (CP) angle simultaneously. A 37-year-old man was admitted to the hospital complaining of headache, nausea, and a floating sensation on August 29, 1984. Neurological examination on admission revealed bilateral papilledema, left dysmetria and horizontal nystagmus. CT scan revealed a slightly high density round mass in the right lateral ventricle and a cystic mass with mural nodule in the left CP angle. The intraventricular mass and mural nodule were enhanced moderately and homogeneously. The initial surgery was for removal of the CP angle tumor, and 8 days later removal of the lateral ventricle tumor was carried out. The histology of these tumors was the same and revealed malignant choroid plexus papilloma. Postoperative radiation therapy was carried out 70Gy to the brain (whole brain; 50Gy, focal; 20Gy) and 30Gy to the whole spine. About 2 years later paraparesis, lower cranial nerve palsy, and disturbance of consciousness had progressed gradually. He died of the severe recurrence of the tumor in the brain stem, and multiple dissemination in the spinal cord on September 6, 1987. There was no recurrence of tumor in the right lateral ventricle. This is a very rare case of malignant choroid plexus papilloma which was revealed in both the supra- and infratentorial regions simultaneously. They may have developed independently or they may have arisen through subarachnoid seeding. Radical removal of the tumor is important to prevent recurrence of malignant choroid plexus papilloma.

摘要

成人恶性脉络丛乳头状瘤病例极为罕见。本报告介绍了一例同时发生于侧脑室和小脑脑桥角的成人恶性脉络丛乳头状瘤病例。一名37岁男性于1984年8月29日因头痛、恶心和漂浮感入院。入院时神经学检查发现双侧视乳头水肿、左侧辨距不良和水平眼球震颤。CT扫描显示右侧侧脑室内有一个略高密度的圆形肿块,左侧小脑脑桥角有一个带壁结节的囊性肿块。脑室内肿块和壁结节呈中度均匀强化。首次手术切除小脑脑桥角肿瘤,8天后切除侧脑室肿瘤。这些肿瘤的组织学表现相同,均为恶性脉络丛乳头状瘤。术后对脑部进行70Gy放疗(全脑;50Gy,局部;20Gy),对全脊柱进行30Gy放疗。约2年后,双下肢轻瘫、低位脑神经麻痹和意识障碍逐渐进展。他于1987年9月6日死于脑干肿瘤严重复发及脊髓多发播散。右侧侧脑室未出现肿瘤复发。这是一例极为罕见的同时发生于幕上和幕下区域的恶性脉络丛乳头状瘤病例。它们可能是独立发生的,也可能是通过蛛网膜下腔播散形成的。彻底切除肿瘤对于预防恶性脉络丛乳头状瘤复发至关重要。

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