Yip Chi-Man, Lee Huai-Pao, Fu Jui-Hsun, Hsu Shuo-Hsiu
Division of Neurosurgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC.
Department of Pathology and Laboratory Medicine, Kaohsiung Veterans General Hospital, Taiwan, ROC.
J Surg Case Rep. 2019 Jan 31;2019(1):rjz013. doi: 10.1093/jscr/rjz013. eCollection 2019 Jan.
Intracranial solitary fibrous tumors are rare mesenchymal neoplasms originating in the meninges and constitute a heterogeneous group of rare spindle cell tumors that include benign and malignant neoplasms of which hemangiopericytoma is nowadays considered a cellular phenotypic variant. From literatures, the incidence of coexistence of brain tumors and intracranial aneurysms is ~0.7-5.4%. Meningioma is the most frequent tumor coexisted with intracranial aneurysms, followed by pituitary adenoma, neuroepithelial tumor, and metastatic tumor. We would like to report a case of 74-year-old man harboring a rare intracranial solitary fibrous tumor/hemangiopericytoma and an unruptured aneurysm of the right middle cerebral artery which probably the first report of these combinations in the English literature. Both lesions were treated surgically in one session with favorable outcome. Magnetic resonance angiography should be performed in patients with brain tumor preoperatively not only to visualize neoplastic vascularization but also to pick up incidental aneurysm.
颅内孤立性纤维瘤是起源于脑膜的罕见间叶性肿瘤，是一组异质性的罕见梭形细胞肿瘤，包括良性和恶性肿瘤，其中血管外皮细胞瘤目前被认为是一种细胞表型变异。从文献来看，脑肿瘤与颅内动脉瘤并存的发生率约为0.7%-5.4%。脑膜瘤是与颅内动脉瘤并存最常见的肿瘤，其次是垂体腺瘤、神经上皮肿瘤和转移瘤。我们报告一例74岁男性，患有罕见的颅内孤立性纤维瘤/血管外皮细胞瘤和右侧大脑中动脉未破裂动脉瘤，这可能是英文文献中关于这些病变组合的首例报道。两个病变在一次手术中得到治疗，效果良好。对于脑肿瘤患者，术前应进行磁共振血管造影，不仅要观察肿瘤的血管化情况，还要发现偶然存在的动脉瘤。
