Karekezi Claire, El Fatemi Nizare, Egu Komi, Ibrahimi Mohamed, El Maaqili Moulay Rachid, El Abbadi Najia
Department of Neurosurgery, Mohamed Vth University, School of Medicine, Hospital Ibn Sina, CHU Ibn Sina, Rabat 10100, Morocco.
Surg Neurol Int. 2016 Mar 4;7:24. doi: 10.4103/2152-7806.178135. eCollection 2016.
Coexistence of multiple primary intracranial tumors of different cell types has rarely been documented; the association of a meningioma and a glioma has been reported as the most common combination. Hereby, we report an unusual case of a temporal epidermoid cyst coexisting with an atypical meningioma.
A 37-year-old male presented with progressive symptoms of raised intracranial progression with progressive loss of vision without any neurological deficit. On admission, magnetic resonance imaging (MRI) revealed a right frontal lesion appearing hypointense T1, hyperintense T2 slightly enhanced after gadolinium and a second right temporal, isointense T1, hyperintense T2 non-enhancing lesion. A right frontotemporal craniotomy was performed that revealed two distinct lesions: The whitish temporal lesion with the pearl appearance reminding of an epidermoid cyst, the second lesion was extraaxial fibrous lesion arising from the falx. Pathology confirmed an atypical meningioma WHO Grade II and an epidermoid cyst.
The simultaneous occurrence of primary intracranial tumors of different cell types is rare. Epidermoid cysts are slow growing lesions believed to arise from inclusion of ectodermal elements during neural tube closure, while meningiomas arise from arachnoidal cells; their association has rarely been reported previously.
不同细胞类型的多种原发性颅内肿瘤共存的情况鲜有文献记载；脑膜瘤和胶质瘤的联合被报道为最常见的组合。在此，我们报告一例颞部表皮样囊肿与非典型脑膜瘤共存的罕见病例。
一名37岁男性，出现颅内压升高的进行性症状，伴有视力逐渐丧失，无任何神经功能缺损。入院时，磁共振成像（MRI）显示右侧额叶病变在T1加权像上呈低信号，T2加权像上呈高信号，钆增强后略有强化，右侧颞叶还有一个T1加权像等信号、T2加权像高信号且无强化的病变。进行了右侧额颞开颅手术，发现两个不同的病变：灰白色的颞部病变呈珍珠样外观，提示为表皮样囊肿，第二个病变是起源于大脑镰的轴外纤维性病变。病理证实为WHO二级非典型脑膜瘤和表皮样囊肿。
不同细胞类型的原发性颅内肿瘤同时发生的情况很少见。表皮样囊肿是生长缓慢的病变，被认为是在神经管闭合期间外胚层成分包埋所致，而脑膜瘤起源于蛛网膜细胞；它们的联合此前鲜有报道。
