Gong Xuan, Liu Chao, Zhang Longbo, Li Zhenyan, Bartley Christopher M, Liu Zhixiong
Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan, China.
Department of Oncology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
World Neurosurg. 2017 Sep;105:1039.e13-1039.e18. doi: 10.1016/j.wneu.2017.06.155. Epub 2017 Jul 3.
Choroid plexus papillomas (CPPs) are rare benign tumors, and the pigmented subtype is observed even more rarely.
We present the case of a 43-year-old woman with complaints of headache and progressive left monocular visual deterioration, whose initial plain computed tomography CT scan showed an ovate high-density tumor located within the insellar region. Magnetic resonance imaging revealed a homogeneously contrast-enhancing tumor extending from the sella turcica to the suprasellar cistern. Single-nostril transsphenoidal endoscopic resection followed by subfrontal subtotal resection was performed in this patient. Postoperative histology revealed that the tumor consisted of hyperchromatic tissue with papillary features. Higher-resolution examination of the tissue revealed this tissue was composed of hyperplastic columnar epithelial cells with hyperchromatic cytoplasmic pigment. Subsequent immunohistochemistry identified the lesion as a pigmented choroid plexus papilloma. Here we review the current literature, discuss the origin of the tumor, the differential diagnosis, and the roles of surgery and radiotherapy.
This case study provides important clinical information for the evaluation, diagnosis, and treatment of pigmented CPP in the sellar region.
脉络丛乳头状瘤(CPPs)是罕见的良性肿瘤,色素沉着亚型更为罕见。
我们报告一例43岁女性,主诉头痛和左眼视力进行性减退,其最初的普通计算机断层扫描(CT)显示蝶鞍区内有一个椭圆形高密度肿瘤。磁共振成像显示一个均匀强化的肿瘤,从蝶鞍延伸至鞍上池。该患者接受了单鼻孔经蝶窦内镜切除术,随后进行额下部分切除术。术后组织学检查显示肿瘤由具有乳头状特征的深染组织组成。对组织进行更高分辨率检查发现,该组织由具有深染细胞质色素的增生柱状上皮细胞组成。随后的免疫组织化学鉴定该病变为色素沉着脉络丛乳头状瘤。在此,我们回顾当前文献,讨论肿瘤的起源、鉴别诊断以及手术和放疗的作用。
本病例研究为蝶鞍区色素沉着CPP的评估、诊断和治疗提供了重要的临床信息。