Hernández-Durán Silvia, Sánchez-Jiménez Esteban, Pérez-Berríos José
University of Costa Rica School of Medicine, Ciudad Universitaria Rodrigo Facio, San Pedro de Montes de Oca, San José, Costa Rica ; Department of Neurological Surgery, Hospital San Juan de Dios, Paseo Colón, San José, Costa Rica.
Department of Neurological Surgery, Hospital San Juan de Dios, Paseo Colón, San José, Costa Rica.
Surg Neurol Int. 2014 Jan 28;5:13. doi: 10.4103/2152-7806.125864. eCollection 2014.
The presentation of intracranial hemangiopericytomas is very rare, and only one case of a hemangiopericytoma during pregnancy has been reported in the literature. The management of these lesions poses a great challenge to the neurosurgeon, since the physiological and hormonal changes of pregnancy can exacerbate the symptoms of this highly vascularized neoplasm and pose different risks to both the mother and the fetus. We report the case of a patient who had sudden onset of intracranial hypertension at the ninth week of gestation due to a hemangiopericytoma of the foramen magnum and review the literature in this regard.
A 23-year-old female who presented with signs and symptoms of intracranial hypertension at the ninth week of gestation was initially thought to have hyperemesis gravidarum. Because her symptoms persisted, she was found to have intracranial hypertension due to a tumor in the foramen magnum. She was treated by means of derivative surgery to allow for her pregnancy to progress beyond the first trimester, and at the 22(nd) week of gestation she underwent a sub-occipital craniotomy with partial tumor removal. Pathology was consistent with hemangiopericytoma. Both the mother and the fetus had positive outcomes.
To our knowledge, this is the second intracranial hemangiopericytoma presenting during pregnancy to be reported in the literature, and it is the first one of its kind to be located in the foramen magnum and causing severe intracranial hypertension.
颅内血管外皮细胞瘤的表现非常罕见,文献中仅报道过1例妊娠期血管外皮细胞瘤。这些病变的处理对神经外科医生构成了巨大挑战,因为妊娠期间的生理和激素变化会加重这种高度血管化肿瘤的症状,并给母亲和胎儿带来不同风险。我们报告1例妊娠9周时因枕骨大孔血管外皮细胞瘤突然出现颅内高压的患者,并回顾这方面的文献。
1名23岁女性在妊娠9周时出现颅内高压的体征和症状,最初被认为是妊娠剧吐。由于其症状持续存在,发现是枕骨大孔处肿瘤导致颅内高压。对其进行了减压手术以便妊娠进入孕中期,在妊娠22周时她接受了枕下开颅并部分切除肿瘤。病理结果符合血管外皮细胞瘤。母亲和胎儿均预后良好。
据我们所知,这是文献中报道的第二例妊娠期出现的颅内血管外皮细胞瘤,也是首例位于枕骨大孔并导致严重颅内高压的此类病例。