Tanabe Nozomu, Tomita Takahiro, Nagai Shoichi, Kuwayama Naoya, Noguchi Kyo, Kuroda Satoshi
Department of Neurosurgery, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama.
No Shinkei Geka. 2016 Oct;44(10):863-867. doi: 10.11477/mf.1436203391.
The authors report a rare case of an intracranial dermoid cyst found in Meckel's cave. A 63-year-old woman developed left oculomotor nerve palsy and was referred to their hospital. Magnetic resonance imaging revealed a cystic lesion in the left Meckel's cave and prepontine cistern, but her symptoms gradually improved during conservative observation. However, three years later she complained of left facial pain in the territory of the second branch of the trigeminal nerve. The left oculomotor nerve palsy exacerbated again. Although her trigeminal neuralgia improved after carbamazepine administration, her oculomotor nerve palsy did not recover. Therefore, she underwent direct surgery through the anterior transpetrosal approach, and the fat-containing tumor cyst was completely resected. The tumor was strongly compressing the left trigeminal nerve and its ganglion in Meckel's cave. After surgery, her facial pain completely resolved and her oculomotor nerve palsy gradually improved. Histological examination revealed that the cyst wall was composed of a single layer of squamous epithelium and contained hair and keratin. A pathological diagnosis of a dermoid cyst was made.
作者报告了一例罕见的位于梅克尔腔的颅内皮样囊肿病例。一名63岁女性出现左侧动眼神经麻痹，被转诊至他们的医院。磁共振成像显示左侧梅克尔腔和脑桥前池有一个囊性病变，但在保守观察期间她的症状逐渐改善。然而，三年后她抱怨三叉神经第二支分布区域出现左侧面部疼痛。左侧动眼神经麻痹再次加重。尽管服用卡马西平后她的三叉神经痛有所改善，但动眼神经麻痹并未恢复。因此，她接受了经岩前入路直接手术，含脂肪的肿瘤囊肿被完全切除。肿瘤在梅克尔腔内强烈压迫左侧三叉神经及其神经节。手术后，她的面部疼痛完全缓解，动眼神经麻痹逐渐改善。组织学检查显示囊肿壁由单层鳞状上皮组成，含有毛发和角蛋白。做出了皮样囊肿的病理诊断。
