Higa Nayuta, Yonezawa Hajime, Oyoshi Tatsuki, Hiraki Tsubasa, Hirano Hirofumi, Arita Kazunori
Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
Department of Human Pathology, Field of Oncology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
NMC Case Rep J. 2016 May 19;3(3):97-101. doi: 10.2176/nmccrj.cr.2016-0038. eCollection 2016 Jul.
Gangliogliomas typically arise in the cerebral hemispheres, but may occur rarely in the ventricles. Herein, we report a 38-year-old woman who was treated for hydrocephalus caused by a ganglioglioma of the third ventricle. Magnetic resonance imaging (MRI) revealed a heterogeneously enhanced tumor occupying the anterior part of the third ventricle. A left trans-lateral ventricular trans-foramen of Monroi approach was effective in achieving subtotal resection of the tumor, which had arisen from the medial part of left thalamus to the hypothalamus. Follow-up MRI showed no recurrence of the tumor 5-years after surgery. On pathological examination, the tumor was composed of a glial component that presented features mimicking pilocytic astrocytoma with proliferations of large gangliocytic cells that stained positive for neuronal markers. A review of six similar cases in the literature, including our own, revealed hydrocephalus to be the main symptom of gangliogliomas, with pituitary insufficiencies and visual disturbances having also been reported. In conclusion, we highlight the importance of gangliogliomas in the differential diagnosis of third ventricular tumors presenting with hydrocephalus.
神经节胶质瘤通常起源于大脑半球，但很少发生于脑室。在此，我们报告一名38岁女性，因第三脑室神经节胶质瘤导致脑积水而接受治疗。磁共振成像（MRI）显示一个不均匀强化的肿瘤占据第三脑室前部。经左侧经侧脑室Monro孔入路有效地实现了肿瘤的次全切除，该肿瘤起源于左侧丘脑内侧至下丘脑。术后5年的随访MRI显示肿瘤无复发。病理检查显示，肿瘤由一个胶质成分组成，其表现出类似毛细胞型星形细胞瘤的特征，伴有大量神经节细胞样细胞增殖，这些细胞对神经元标志物呈阳性染色。对包括我们自己的病例在内的文献中6例类似病例的回顾显示，脑积水是神经节胶质瘤的主要症状，也有垂体功能不全和视觉障碍的报道。总之，我们强调神经节胶质瘤在鉴别诊断伴有脑积水的第三脑室肿瘤中的重要性。
