Kalimullah Jan, Sohail Abdul Malik Amir Humza, Shahjehan Rai Dilawar, Siddique Sabeehuddin, Bari Muhammad Ehsan
Department of Neurosurgery and Surgery, Aga Khan University, Karachi, Pakistan.
Medical College, Aga Khan University, Karachi, Pakistan.
Surg Neurol Int. 2015 Oct 7;6(Suppl 17):S440-3. doi: 10.4103/2152-7806.166771. eCollection 2015.
Neurofibromatosis type 2 (NF2) is an autosomal dominant syndrome with a frequency of 1 in 25,000 live births and a penetrance of almost 100% by the sixth decade of life. The main tumors occurring in NF2 patients are bilateral vestibular schwannomas, other peripheral, cranial and spinal nerve schwannomas, intracranial and intraspinal meningiomas, ependymomas, and gliomas.
We report the case of a 6-year-old boy who presented with a 1-month history of nausea and recurrent vomiting. Physical examination was positive for ataxic gait and left-sided facial nerve palsy. Family history was positive for NF2 in the patient's father and paternal uncle. Magnetic resonance imaging brain revealed a solid enhancing lesion arising from the right cerebellar cortex, which was effacing the fourth ventricles and causing hydrocephalus. Craniotomy and excision of the lesion were performed. Histopathology report confirmed the diagnosis to be desmoplastic medulloblastoma. Based on the patients' subsequent history and family history, he was diagnosed to be a case of NF2.
This is the first case of medulloblastoma occurring in a patient with NF2 and raises the possibility of an association between medulloblastoma and NF2.
2型神经纤维瘤病(NF2)是一种常染色体显性综合征,在活产婴儿中的发病率为1/25000,到60岁时几乎100%会发病。NF2患者主要发生的肿瘤为双侧前庭神经鞘瘤、其他周围神经、颅神经和脊神经神经鞘瘤、颅内和脊髓内脑膜瘤、室管膜瘤和胶质瘤。
我们报告一名6岁男孩的病例,该男孩有1个月的恶心和反复呕吐病史。体格检查发现共济失调步态和左侧面神经麻痹阳性。患者的父亲和叔父有NF2家族史阳性。脑部磁共振成像显示右小脑皮质有一个实性强化病变,该病变压迫第四脑室并导致脑积水。进行了开颅手术并切除了病变。组织病理学报告证实诊断为促纤维增生性髓母细胞瘤。根据患者的后续病史和家族史,他被诊断为NF2病例。
这是首例发生在NF2患者中的髓母细胞瘤病例,提示髓母细胞瘤与NF2之间可能存在关联。