Matsuura Chie, Sakaeyama Yuuki, Node Yasuhiro, Ueda Keita, Ando Shunpei, Masuda Hiroyuki, Kondo Kosuke, Harada Naoyuki, Nemoto Masaaki, Sugo Nobuo
Department of Neurosurgery(Omori), School of Medicine, Faculty of Medicine, Toho University.
No Shinkei Geka. 2018 Dec;46(12):1073-1079. doi: 10.11477/mf.1436203870.
Hemorrhagic low-grade glioma(LGG)without malignant transformation is rare, accounting for less than 1% of cases. To the best of our knowledge, hemorrhagic LGG with an arteriovenous(AV)shunt has not been reported. We report the case of 17-year-old man with LGG with an AV shunt. He presented to our hospital with seizure. Computed tomography(CT)demonstrated a hypodense lesion with mass effect in the right frontal lobe. T1-weighted images(WI)and T2WI on magnetic resonance imaging(MRI)revealed acute-onset hemorrhage in the right frontal lobe. Furthermore, a ring-enhancing lesion was noted on gadolinium(Gd)-DTPA T1WI, and an AV shunt was found in the same region on angiography. Gross total tumor resection was performed. The pathological diagnosis was diffuse astrocytoma with pilomyxoid features(WHO grade II). Without adjuvant therapy, no residual tumor was found on MRI at the 6-year follow-up examination. We treated a case of hemorrhagic LGG with an AV shunt. Intratumoral hemorrhage in LGG may occur and should be considered for the differential diagnosis.
无恶性转化的出血性低级别胶质瘤（LGG）较为罕见，占病例的比例不到1%。据我们所知，伴有动静脉（AV）分流的出血性LGG尚未见报道。我们报告一例17岁患有伴有AV分流的LGG男性病例。他因癫痫发作前来我院就诊。计算机断层扫描（CT）显示右侧额叶有一个具有占位效应的低密度病变。磁共振成像（MRI）的T1加权图像（WI）和T2WI显示右侧额叶急性出血。此外，钆（Gd）-二乙三胺五乙酸（DTPA）T1WI上可见环形强化病变，血管造影在同一区域发现AV分流。进行了肿瘤全切除。病理诊断为具有毛黏液样特征的弥漫性星形细胞瘤（世界卫生组织二级）。在6年的随访检查中，未进行辅助治疗，MRI未发现残留肿瘤。我们治疗了一例伴有AV分流的出血性LGG病例。LGG中可能发生瘤内出血，应考虑进行鉴别诊断。
