Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
World Neurosurg. 2019 Jul;127:525-529. doi: 10.1016/j.wneu.2019.04.084. Epub 2019 Apr 17.
Primary extracranial meningiomas are uncommon neoplasms. In particular, meningioma involving the hypoglossal canal is extremely rare, with only 4 cases reported in the literature so far. Given that each of these meningiomas originated in the juxtacondyle region with involvement of the hypoglossal canal, to the best of our knowledge, a meningioma that exists only within the hypoglossal canal has yet to be reported.
We present a case of primary extracranial meningioma arising solely from the hypoglossal canal. A 62-year-old woman presented with long-term difficulty in tongue movement. Her tongue was deviated to the right, and neurologic examination revealed fasciculation and muscle wasting on the right side of the tongue. Computed tomography revealed a calcification in the right hypoglossal canal. Magnetic resonance imaging further demonstrated a hypointense tumor on both T1-weighted and T2-weighted images, with contrast enhancement in the right condyle. Total tumor removal was performed via a transcondylar approach, and histopathologic examination confirmed the presence of a transitional meningioma. No recurrence was observed at 14 months of follow-up. The patient's tongue atrophy was slightly improved, and the deviation completely disappeared.
In this extremely rare case of hypoglossal canal meningioma, total tumor removal via a transcondylar approach resulted in the recovery of hypoglossal nerve function.
原发性颅外脑膜瘤并不常见。特别是累及舌下神经管的脑膜瘤极为罕见，迄今为止文献中仅报道了 4 例。鉴于这些脑膜瘤均起源于髁突旁区域并累及舌下神经管，据我们所知，目前尚未报道仅存在于舌下神经管内的脑膜瘤。
我们报告了一例原发性颅外脑膜瘤，仅起源于舌下神经管。一名 62 岁女性长期出现舌运动困难。她的舌头向右侧偏斜，神经检查显示右侧舌肌有束颤和肌肉萎缩。计算机断层扫描显示右侧舌下神经管内有钙化。磁共振成像进一步显示 T1 加权和 T2 加权图像上均为低信号肿瘤，右侧髁突有增强。通过经髁突入路行全肿瘤切除术，组织病理学检查证实为过渡型脑膜瘤。随访 14 个月未见复发。患者的舌萎缩略有改善，偏斜完全消失。
在这个极为罕见的舌下神经管脑膜瘤病例中，经髁突入路行全肿瘤切除术可恢复舌下神经功能。
