Jeong Tae Seok, Yee Gi Taek, Kim Na Rae
Department of Neurosurgery, Gil Medical Center, Gachon University, Incheon, Korea.
Department of Pathology, Gil Medical Center, Gachon University, Incheon, Korea.
J Korean Neurosurg Soc. 2017 Jan 1;60(1):108-113. doi: 10.3340/jkns.2015.0707.022. Epub 2016 Dec 29.
Craniopharyngiomas exhibiting histologic malignancy are extremely rare. Herein, we report the case of a 26-year-old male patient who underwent suprasellar mass excision via an interhemispheric transcallosal approach. Histopathological examination indicated that the craniopharyngioma was of the adamantinomatous subtype. The patient received postoperative medical treatment for endocrine dysfunction and diabetes mellitus without radiation treatment. Two years after the operation, he presented with progressive visual disturbance and altered mentality. Magnetic resonance imaging revealed a huge mass in the suprasellar cistern and third ventricle. He underwent a second operation via the same approach. The histopathological examination showed an adamantinomatous craniopharyngioma with sheets of solid proliferation in a spindled pattern, indicating malignant transformation. Malignant transformation of craniopharyngioma in the absence of radiation therapy has been reported in only five cases, including this one. We present a case of malignant transformation of craniopharyngioma with a brief review of relevant literature.
组织学上表现为恶性的颅咽管瘤极为罕见。在此，我们报告一例26岁男性患者，该患者通过经胼胝体间入路进行了鞍上肿物切除术。组织病理学检查表明该颅咽管瘤为成釉细胞瘤亚型。患者术后接受了针对内分泌功能障碍和糖尿病的药物治疗，未进行放射治疗。术后两年，他出现进行性视力障碍和精神状态改变。磁共振成像显示鞍上池和第三脑室内有巨大肿物。他通过相同入路接受了第二次手术。组织病理学检查显示为成釉细胞瘤型颅咽管瘤，呈梭形实性片状增生，提示恶性转化。仅包括本病例在内的5例报道了未接受放射治疗的颅咽管瘤发生恶性转化的情况。我们报告一例颅咽管瘤恶性转化病例，并对相关文献进行简要回顾。
