Isobe Naoyuki, Nishimoto Takeshi, Ueda Takeshi
Department of Neurosurgery, JA Onomichi General Hospital.
No Shinkei Geka. 2017 Aug;45(8):707-713. doi: 10.11477/mf.1436203579.
Pilocytic astrocytomas are found predominantly in the pediatric population and are extremely rare in elderly patients. We describe a case of pilocytic astrocytoma in an elderly patient who presented with the symptoms of an enlarged tumoral cyst. A 70-year-old woman was found to have an asymptomatic small solid tumor with a cystic component in the right frontal lobe at "Ningen Dock(medical checkup)of the Brain". She was hospitalized and underwent further examinations including cerebral angiography. At that time, she was opposed to undergoing an operation for tumor removal owing to lack of symptoms. Approximately fourteen years later, she presented with dizziness upon posture conversion and recent memory disturbance. Computed tomography scanning revealed an enlarged cyst in the frontal lobe and perifocal edematous changes. Gadolinium-enhanced magnetic resonance imaging partially revealed the solid tumor and cystic capsule. The solid tumor had not enlarged substantially. The cystic fluid was aspirated and the solid tumor was resected via a frontal transcortical approach. The histological diagnosis was pilocytic astrocytoma without malignant features. After surgery, the patient's symptoms improved and additional therapy was not provided. After a year of postoperative follow-up, the size of the cystic lesion has reduced, and no recurrence of the solid tumor has been observed.
毛细胞型星形细胞瘤主要见于儿童群体，在老年患者中极为罕见。我们描述了一例老年毛细胞型星形细胞瘤患者，该患者表现为肿瘤性囊肿增大的症状。一名70岁女性在“脑部体检”时被发现右额叶有一个无症状的小实性肿瘤，伴有囊性成分。她住院并接受了包括脑血管造影在内的进一步检查。当时，由于没有症状，她拒绝接受肿瘤切除手术。大约14年后，她出现体位转换时头晕和近期记忆障碍。计算机断层扫描显示额叶囊肿增大，周围有水肿改变。钆增强磁共振成像部分显示了实性肿瘤和囊性包膜。实性肿瘤没有明显增大。抽出囊液并通过额部经皮质入路切除实性肿瘤。组织学诊断为无恶性特征的毛细胞型星形细胞瘤。手术后，患者症状改善，未进行额外治疗。术后随访一年，囊性病变大小减小，未观察到实性肿瘤复发。
