Kuo Chao-Hung, Yen Yu-Shu, Tu Tsung-Hsi, Wu Jau-Ching, Huang Wen-Cheng, Cheng Henrich
Neurosurgery, Taipei Veterans General Hospital, Taipei, TWN.
Cureus. 2018 Jun 20;10(6):e2849. doi: 10.7759/cureus.2849.
Choroid plexus papillomas (CPPs) are slow-growing and benign tumors, representing less than 1% of all intracranial neoplasms. They are predominantly located in the lateral ventricles in children, and in the fourth ventricle in adults. Primary CPP over sellar regions is extremely rare. There was previously only one case reported in men. We report the case of a 43-year-old male who initially presented with bilateral temporal hemiapnosia. A brain magnetic resonance imaging (MRI) revealed heterogenous enhanced mass lesion with cyst component compressing upward onto the optic chiasm. A craniopharyngioma was initially suspected. Further endoscopic trans-sphenoidal surgery (ETS) was performed for total tumor resection. After surgery, the patient had visual field improved without tumor recurrence on post-operative MRI in clinical follow-up. Histopathological examination of the lesion confirmed the diagnosis of CPP, with fibrovascular cores covered by a single layer of cuboidal to columnar epithelial cells. CPP is a rare tumor without specific clinical patterns or imaging findings. Therefore, pre-operative differential diagnosis is difficult for this kind of tumor with complete separation from ventricular system. An ETS for total tumor resection provided effective treatment.
脉络丛乳头状瘤(CPPs)是生长缓慢的良性肿瘤,占所有颅内肿瘤的比例不到1%。它们主要位于儿童的侧脑室和成人的第四脑室。鞍区原发性CPP极其罕见。此前仅报道过1例男性病例。我们报告1例43岁男性,最初表现为双侧颞叶偏盲。脑部磁共振成像(MRI)显示不均匀强化的肿块病变,伴有囊肿成分,向上压迫视交叉。最初怀疑为颅咽管瘤。进一步行内镜经蝶窦手术(ETS)以完全切除肿瘤。术后,患者视野改善,临床随访的术后MRI显示无肿瘤复发。病变的组织病理学检查确诊为CPP,其纤维血管核心被单层立方到柱状上皮细胞覆盖。CPP是一种罕见肿瘤,没有特定的临床模式或影像学表现。因此,对于这种与脑室系统完全分离的肿瘤,术前鉴别诊断困难。ETS完全切除肿瘤提供了有效的治疗方法。