Asmaro Karam, Arshad Muzamil, Massie Lara, Griffith Brent, Lee Ian
Department of Neurosurgery, Henry Ford Health System, Detroit, Michigan, USA.
Department of Neurosurgery, Henry Ford Health System, Detroit, Michigan, USA.
World Neurosurg. 2019 Mar;123:e31-e38. doi: 10.1016/j.wneu.2018.10.198. Epub 2018 Nov 4.
Atypical teratoid/rhabdoid tumors (ATRT) are uncommon malignancies of the central nervous system and are often difficult to distinguish radiographically and pathologically from other common tumors. We present the first case of sellar ATRT presenting with subarachnoid hemorrhage (SAH) and intraventricular hemorrhage (IVH).
A 62-year-old woman, who had presented with symptoms of headache, diabetes insipidus, hypothyroidism, and seizures, was found to have a sellar tumor with hemorrhagic transformation. Surgical resection was performed. The pathological examination findings were consistent with ATRT. Despite early surgical intervention, she later died before starting craniospinal radiotherapy and chemotherapy.
To the best of our knowledge, although known to present with intratumoral hemorrhage, to date, no cases of sellar ATRT have presented with SAH or IVH have been reported. Considering our finding that ATRT can present with SAH and IVH, establishing the correct diagnosis using radiographic imaging, gender, pathological findings, and molecular markers is paramount for speedy treatment and management.
非典型畸胎样/横纹肌样肿瘤（ATRT）是中枢神经系统罕见的恶性肿瘤，在影像学和病理学上常难以与其他常见肿瘤区分。我们报告首例鞍区ATRT伴蛛网膜下腔出血（SAH）和脑室内出血（IVH）。
一名62岁女性，出现头痛、尿崩症、甲状腺功能减退和癫痫症状，被发现患有鞍区肿瘤并伴有出血性转化。进行了手术切除。病理检查结果与ATRT一致。尽管早期进行了手术干预，但她后来在开始颅脊髓放疗和化疗之前死亡。
据我们所知，尽管已知ATRT可出现肿瘤内出血，但迄今为止，尚无鞍区ATRT伴SAH或IVH的病例报道。鉴于我们发现ATRT可伴有SAH和IVH，利用影像学检查、性别、病理结果和分子标志物进行正确诊断对于快速治疗和管理至关重要。
