Miki Kenji, Yoshimoto Koji, Nishimura Ataru, Suzuki Satoshi O, Hiwatashi Akio, Iihara Koji
Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
World Neurosurg. 2017 Sep;105:1033.e11-1033.e14. doi: 10.1016/j.wneu.2017.06.003. Epub 2017 Jun 9.
Ecchordosis physaliphora (EP) is a benign notochordal remnant that is usually asymptomatic. We report a case of a symptomatic large EP mimicking an epidermoid cyst.
A 44-year-old woman presented with right facial dysesthesia. Brain magnetic resonance imaging showed a mass with a diameter of 3.2 cm that was hypointense on T1-weighted imaging, hyperintense on T2-weighted imaging, isointense to hyperintense on diffusion-weighted imaging, and hyperintense on apparent diffusion coefficient map (1.2-1.6 × 10 mm/second). There was no apparent contrast enhancement. Differential diagnoses included epidermoid cyst, dermoid cyst, EP, chordoma, chondrosarcoma, neurenteric cyst, and arachnoid cyst. Clinicopathologic examination revealed that the mass was an EP.
EP in the prepontine cistern should be considered in the differential diagnosis of epidermoid cyst.
泡状脊索瘤（EP）是一种通常无症状的良性脊索残余物。我们报告一例有症状的巨大EP，其表现类似表皮样囊肿。
一名44岁女性出现右侧面部感觉异常。脑部磁共振成像显示一个直径3.2 cm的肿块，在T1加权成像上呈低信号，在T2加权成像上呈高信号，在扩散加权成像上呈等信号至高信号，在表观扩散系数图上呈高信号（1.2 - 1.6×10⁻³ mm²/秒）。无明显对比增强。鉴别诊断包括表皮样囊肿、皮样囊肿、EP、脊索瘤、软骨肉瘤、神经肠囊肿和蛛网膜囊肿。临床病理检查显示该肿块为EP。
脑桥前池的EP在表皮样囊肿的鉴别诊断中应予以考虑。
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