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后颅窝罕见的天幕间叶性软骨肉瘤:病例报告。

A rare tentorial mesenchymal chondrosarcoma in posterior cranial fossa: case report.

机构信息

Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, PR China.

Department of Radiology, West China Hospital, Sichuan University, Chengdu, PR China.

出版信息

Neurol Neurochir Pol. 2014;48(4):287-91. doi: 10.1016/j.pjnns.2014.06.001. Epub 2014 Jun 27.

Abstract

Intracranial extraskeletal mesenchymal chondrosarcoma is a very rare malignant tumor with predilection site of frontoparietal falx cerebri. Only few cases of mesenchymal chondrosarcoma in posterior cranial fossa are reported. Here, we report a 23-year-old young man with a dura-attached mass in left posterior cranial fossa misdiagnosed as a tentorial meningioma preoperatively. According to the following operation, the lesion was confirmed as mesenchymal chondrosarcoma surgically and pathologically. On MRI, the tumor was characterized by lobulated soft-tissue mass with dura-attached base, patchy calcifications and heterogeneous signal intensities. On contrast-enhanced MRI, it was well-defined, with marked enhancement. We consider that these imaging features above might remind us to consider the diagnosis of mesenchymal chondrosarcoma in posterior cranial fossa. The postoperative treatment of radiotherapy is still controversial. As for our case, according to the 24 months follow-up after postoperative γ-knife, our patient shows an optimistic prognosis so far.

摘要

颅内骨外间叶性软骨肉瘤是一种非常罕见的恶性肿瘤,好发于额顶镰。仅有少数颅后窝间叶性软骨肉瘤的病例报道。本文报道了 1 例 23 岁青年男性,术前诊断为左颅后窝镰旁硬脑膜附着肿块,误诊为天幕脑膜瘤。根据手术病理,病变被确认为间叶性软骨肉瘤。MRI 表现为分叶状软组织肿块,与硬脑膜相连,有斑片状钙化和不均匀信号强度。增强 MRI 上边界清楚,明显强化。我们认为这些影像学特征可能有助于我们考虑颅后窝间叶性软骨肉瘤的诊断。术后放疗的治疗仍存在争议。对于我们的病例,根据术后 γ-刀治疗 24 个月的随访,我们的患者目前预后乐观。

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