Rotim Krešimir, Sajko Tomislav, Zmajević Marina, Šumonja Ilijana, Grgić Marko
Acta Clin Croat. 2015 Jun;54(2):227-31.
A case is presented of a patient with dysphonia, hearing loss and ataxia due to vestibulocochlear and vagal nerve compression by choroid plexus papilloma in the cerebellopontine angle. Choroid plexus papillomas are rare tumors usually arising in the lateral and fourth ventricle, and rarely found in the cerebellopontine angle, making the neuroimaging characteristics usually not sufficient for diagnosis. Patients usually present with headache and hydrocephalus but tumors in the cerebellopontine angle can cause vestibulocochlear dysfunction and cerebellar symptoms. Dysphonia along with hearing loss was a dominant symptom in the case presented. After complete surgical removal of the tumor, deterioration of dysphonia was noticed; it could be explained as peripheral vagal nerve neuropathy due to tumor compression and intraoperative manipulation. In this case report, we describe dysphonia as an uncommon presentation of a rare posterior fossa tumor. To our knowledge, a case of choroid plexus papilloma presenting with dysphonia has not been described before. Our case extends the differential diagnosis of dysphonia from the otorhinolaryngological to the neurosurgical field.
本文报告一例因小脑桥脑角脉络丛乳头状瘤压迫前庭蜗神经和迷走神经而出现声音嘶哑、听力丧失和共济失调的患者。脉络丛乳头状瘤是一种罕见的肿瘤，通常发生在侧脑室和第四脑室，很少见于小脑桥脑角，因此其神经影像学特征通常不足以用于诊断。患者通常表现为头痛和脑积水，但小脑桥脑角的肿瘤可导致前庭蜗功能障碍和小脑症状。在本病例中，声音嘶哑伴听力丧失是主要症状。肿瘤完全切除后，发现声音嘶哑加重；这可以解释为肿瘤压迫和术中操作导致的外周迷走神经病变。在本病例报告中，我们将声音嘶哑描述为一种罕见的后颅窝肿瘤的不常见表现。据我们所知，此前尚未有脉络丛乳头状瘤表现为声音嘶哑的病例报道。我们的病例扩展了声音嘶哑的鉴别诊断范围，从耳鼻喉科领域扩展到了神经外科领域。
