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[颈静脉球瘤伴颅内及颅外扩展:一例报告及MRI研究]

[Glomus jugulare tumor with intra- and extracranial extension: a case report with MRI study].

作者信息

Morisako T, Goya T, Wakisaka S, Kinoshita K

机构信息

Department of Neurosurgery, Miyazaki Medical College, Japan.

出版信息

No Shinkei Geka. 1987 Nov;15(11):1227-31.

PMID:2830549
Abstract

A case of glomus jugulare tumor with intra- and extracranial extension is described. The patient was a 63-year-old woman who complained of gait and memory disturbances. On admission neurological examination revealed recent memory disturbance, left deafness, left XI, XIIth cranial nerve palsies, and slight ataxic gait. Roentgenogram of the skull showed an enlarged left jugular foramen with bone erosion. Plain X-ray computerized tomography scan (X-CT) indicated obstructive hydrocephalus and X-CT with contrast enhancement revealed a mass lesion in the left posterior cranial fossa extending through enlarged left jugular foramen to the extracranial space toward the level of C2. Cerebral angiography demonstrated a large mass with blood supply from branches of left external carotid and vertebral arteries. The tumor stain was not remarkable. Left internal jugular vein was completely obstructed at the level of the second cervical vertebral body. Magnetic resonance imaging (MRI) clearly showed the tumor extending from the anterolateral portion to the second cervical vertebral body through the enlarged jugular foramen to the posterior cranial fossa. Brain stem and cerebellar hemisphere which were markedly compressed by the mass were clearly visualized. At first a ventriculo-peritoneal shunt was made and four weeks later subtotal removal of the tumor was undertaken. Histopathology of tumor specimen showed typical glomus jugulare tumor. MRI was considered to be very useful for the diagnosis and treatment of the glomus jugulare tumor with intra- and extracranial extension.

摘要

本文描述了一例伴有颅内和颅外扩展的颈静脉球瘤病例。患者为一名63岁女性,主诉步态和记忆障碍。入院时神经系统检查发现近期记忆障碍、左耳失聪、左侧第XI、XII对脑神经麻痹以及轻度共济失调步态。颅骨X线片显示左侧颈静脉孔扩大并伴有骨质侵蚀。普通X线计算机断层扫描(X-CT)显示梗阻性脑积水,增强X-CT显示左后颅窝有一肿块病变,通过扩大的左侧颈静脉孔延伸至颅外间隙至C2水平。脑血管造影显示一个大肿块,由左颈外动脉和椎动脉分支供血。肿瘤染色不明显。左颈内静脉在第二颈椎体水平完全阻塞。磁共振成像(MRI)清楚地显示肿瘤从前外侧部分通过扩大的颈静脉孔延伸至第二颈椎体并进入后颅窝。被肿块明显压迫的脑干和小脑半球清晰可见。最初进行了脑室-腹腔分流术,四周后进行了肿瘤次全切除。肿瘤标本的组织病理学显示为典型的颈静脉球瘤。MRI被认为对伴有颅内和颅外扩展的颈静脉球瘤的诊断和治疗非常有用。

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