Hayashi Takuro, Inamasu Joji, Kanai Ryuichi, Sasaki Hikaru, Shinoda Jun, Hirose Yuichi
Department of Neurosurgery, Eiju General Hospital, Tokyo, Japan.
Neurol Med Chir (Tokyo). 2012;52(8):611-6. doi: 10.2176/nmc.52.611.
A 71-year-old woman presented with a rare case of geriatric ependymoma originating from the fourth ventricle manifesting as progressive gait and memory disturbance. Imaging studies revealed an extraaxial mass in the fourth ventricle protruding into the right cerebellomedullary cistern, with concomitant obstructive hydrocephalus. Surgery achieved subtotal removal since the tumor tightly adhered to the right vestibular area of the fourth ventricular floor. The histological diagnosis was ependymoma, which was also confirmed by comparative genetic hybridization. Although she developed severe laryngeal edema and worsening of the hydrocephalus postoperatively which required additional treatment, she recovered with residual mild gait disturbance, and was transferred to a rehabilitation facility. Fourth ventricle ependymoma in the elderly is rare. Comparative genetic hybridization may be important in the diagnosis of geriatric ependymoma and in the choice for adjuvant therapy as well as in estimating the prognosis for patients with rare types of ependymoma.
一名71岁女性患者，患有一例罕见的源自第四脑室的老年室管膜瘤，表现为进行性步态和记忆障碍。影像学检查显示第四脑室外轴性肿块突入右侧小脑延髓池，并伴有梗阻性脑积水。由于肿瘤与第四脑室底部右侧前庭区紧密粘连，手术实现了次全切除。组织学诊断为室管膜瘤，比较基因组杂交也证实了这一诊断。尽管她术后出现严重喉水肿和脑积水加重，需要进一步治疗，但她恢复后仍有轻度步态障碍，并被转至康复机构。老年第四脑室室管膜瘤罕见。比较基因组杂交在老年室管膜瘤的诊断、辅助治疗选择以及评估罕见类型室管膜瘤患者的预后方面可能具有重要意义。
