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脑室内上皮样胶质母细胞瘤:一例报告

Intraventricular Epithelioid Glioblastoma: A Case Report.

作者信息

Nitta Naoki, Moritani Suzuko, Fukami Tadateru, Yoshimura Yayoi, Hirai Hisao, Nozaki Kazuhiko

机构信息

Department of Neurosurgery, Shiga University of Medical Science, Otsu, Japan; National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan.

Division of Diagnostic Pathology, Department of Clinical Laboratory Medicine, Shiga University of Medical Science, Otsu, Japan.

出版信息

World Neurosurg. 2018 Apr;112:257-263. doi: 10.1016/j.wneu.2018.01.200. Epub 2018 Feb 6.

Abstract

BACKGROUND

Epithelioid glioblastoma, a high-grade, diffuse astrocytic tumor variant, comprises closely packed epithelioid cells and rhabdoid cells. This rare tumor usually develops in the cerebral cortex and diencephalon; however, in the case reported here, it was located intraventricularly.

CASE DESCRIPTION

A 47-year-old woman was referred to our hospital with a right intraventricular mass that had rapidly increased in size. On discovery of the tumor 3 years earlier at the referring hospital, the mass was small, calcified, and attached to the periventricular parenchyma. Over the next 2 years, the mass grew slowly, as observed on periodic magnetic resonance imaging scans. Forty days before the referral, the patient experienced headache and nausea, and marked growth and intratumoral hemorrhage were visible on a computed tomography scan of the head. The tumor was partially removed via a superior parietal lobule corticotomy. Histopathological examination confirmed an isocitrate dehydrogenase-wild-type epithelioid glioblastoma with a BRAF V600E mutation, but the original slow-growing lesion was no longer detected. Consequently, we assume that in this case, a low-grade glioma transformed into an aggressively malignant epithelioid glioblastoma.

CONCLUSIONS

We present the first case of an intraventricular epithelioid glioblastoma that might have arisen from a low-grade glioma with calcification. We recommend including this tumor variant in the differential diagnosis of lateral ventricle tumors.

摘要

背景

上皮样胶质母细胞瘤是一种高级别弥漫性星形细胞瘤变体,由紧密排列的上皮样细胞和横纹肌样细胞组成。这种罕见肿瘤通常发生于大脑皮质和间脑;然而,在本文报道的病例中,肿瘤位于脑室内。

病例描述

一名47岁女性因右侧脑室内肿块迅速增大被转诊至我院。3年前在转诊医院发现肿瘤时,肿块较小,有钙化,且附着于脑室周围实质。在接下来的2年中,经定期磁共振成像扫描观察,肿块生长缓慢。转诊前40天,患者出现头痛和恶心,头部计算机断层扫描显示肿块明显增大且瘤内出血。通过顶叶上小叶皮质切开术部分切除肿瘤。组织病理学检查证实为异柠檬酸脱氢酶野生型上皮样胶质母细胞瘤,伴有BRAF V600E突变,但未再检测到最初生长缓慢的病变。因此,我们推测在该病例中,低级别的胶质瘤转变为侵袭性恶性上皮样胶质母细胞瘤。

结论

我们报告了首例可能起源于伴有钙化的低级别的胶质瘤的脑室内上皮样胶质母细胞瘤病例。我们建议在侧脑室肿瘤的鉴别诊断中纳入这种肿瘤变体。

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