Renfrow Jaclyn J, Greeneway Garret P, Carter Lacey, Couture Daniel E
1Department of Neurological Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina; and.
2Department of Neurological Surgery, University of Oklahoma, Oklahoma City, Oklahoma.
J Neurosurg Pediatr. 2018 Oct;22(4):393-396. doi: 10.3171/2018.4.PEDS18112. Epub 2018 Jun 29.
Craniopharyngiomas frequently recur locally or less commonly along the path of prior resection. Ectopic recurrence is rare, although cases are reported along the neuraxis spanning from the subgaleal space down to the S1 nerve root. This case reports on a girl with a history of craniopharyngioma first resected at 23 months of age with two local suprasellar recurrences managed with repeat craniotomy and external beam radiation therapy. At age 14 she complained of worsening headaches and brain MRI demonstrated an enhancing 1.2-cm cystic lesion in the posterior body of the left lateral ventricle. Pathology following endoscopic resection of the lesion was consistent with an adamantinomatous craniopharyngioma. This case report serves to describe the first reported recurrence of a craniopharyngioma in the lateral ventricle and emphasizes the need for a high index of suspicion along with long-term follow-up of patients with a history of craniopharyngioma.
颅咽管瘤经常在局部复发,或较少见地沿先前切除路径复发。异位复发罕见,尽管有病例报道沿神经轴从帽状腱膜下间隙至S1神经根。本病例报告了一名有颅咽管瘤病史的女孩,她在23个月大时首次接受切除,之后有两次鞍上局部复发,通过重复开颅手术和外照射放疗进行治疗。14岁时,她主诉头痛加重,脑部磁共振成像(MRI)显示左侧脑室后体部有一个1.2厘米的强化囊性病变。对该病变进行内镜切除后的病理结果与造釉细胞瘤型颅咽管瘤一致。本病例报告旨在描述首次报道的颅咽管瘤在侧脑室复发的情况,并强调对有颅咽管瘤病史的患者需要高度怀疑并进行长期随访。