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海绵窦内血管母细胞瘤的病例报告:1例极其罕见的病例

Presentation of a Hemangioblastoma in cavernous sinus: An extremely rare case report.

作者信息

Tabibkhooei A, Fattahi A, Rahatlou H

机构信息

Neurosurgery, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Int J Surg Case Rep. 2018;44:54-56. doi: 10.1016/j.ijscr.2018.02.019. Epub 2018 Feb 17.

Abstract

INTRODUCTION

Hemangioblastoma (HB) is a benign vascular tumor that accounts for about 2% of intracranial neoplasms. HB of the cavernous sinus (CS) is extremely rare. Only one report was found in the literature.

PRESENTATION OF CASE

We present a 29-year-old female with progressive headache and she had right ptosis and right mild oculomotor nerve palsy. The brain Magnetic Resonance Imaging (MRI) revealed a right extra-axial 4 × 4 cm in right CS position. The patient was operated upon microscopically via sub-temporal approach through a right temporal craniotomy. After the subtotal removal of a highly vascular tumor, the patient was referred for adjuvant therapy with Gamma-knife surgery.

DISCUSSION

Surgical removal of HB is the most effective treatment of the central nervous system (CNS) HBs. Tumors invading the CS could cause severe bleeding during surgery and HB-because of its vascular origin-had more risk for severe intraoperative bleeding, and in some cases resulted in surgery stop with subtotal resection of tumor.

CONCLUSION

It was recommended to perform a pre-operative brain angiography and selective embolization of these highly vascular lesions that it could result in subsequent complete surgical removal.

摘要

引言

血管母细胞瘤(HB)是一种良性血管肿瘤,约占颅内肿瘤的2%。海绵窦(CS)血管母细胞瘤极为罕见。文献中仅发现一例报告。

病例介绍

我们报告一名29岁女性,患有进行性头痛,伴有右侧上睑下垂和右侧轻度动眼神经麻痹。脑部磁共振成像(MRI)显示右侧海绵窦位置有一个4×4厘米的轴外肿块。患者通过右侧颞部开颅经颞下入路进行显微镜下手术。在次全切除高度血管化肿瘤后,患者接受伽玛刀手术辅助治疗。

讨论

手术切除HB是中枢神经系统(CNS)HB最有效的治疗方法。侵犯海绵窦的肿瘤在手术中可能导致严重出血,并且由于HB起源于血管,术中严重出血的风险更高,在某些情况下导致手术因肿瘤次全切除而停止。

结论

建议术前行脑血管造影和对这些高度血管化病变进行选择性栓塞,这可能导致随后肿瘤的完全手术切除。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c19/5927805/62071335ee14/gr1v5.jpg

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