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诊断罕见的脑室神经鞘瘤。

Diagnosis of a Rare Intraventricular Schwannoma.

机构信息

Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan.

Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan.

出版信息

World Neurosurg. 2020 Feb;134:145-149. doi: 10.1016/j.wneu.2019.09.137. Epub 2019 Oct 4.

Abstract

BACKGROUND

Intraventricular schwannoma is extremely rare, with only 35 cases reported to date in the literature. Consequently, its etiology and pathogenesis are still unclear, and therefore require further investigations. Here, we report on and discuss a rare case of intraventricular schwannoma to elucidate on this matter.

CASE DESCRIPTION

A 26-year-old man was admitted to our institution with a 1-month history of headaches and left hemianopsia. At diagnosis, magnetic resonance imaging of the brain revealed a well-demarcated mass with surrounding edema in the right lateral ventricle. Total resection of the tumor was performed by a transsulcal approach through the right parietal lobe. In surgery, it was observed that the tumor was attached to the choroid plexus without invading the wall of the right lateral ventricle. The respective histologic examination confirmed the diagnosis of intraventricular schwannoma. Six months after the surgery, there was no recurrence. Additionally, during this follow-up period, the patient did not develop any neurologic deficit, including visual field narrowing or parietal symptoms, such as acalculia and right-left, finger, and space agnosias.

CONCLUSIONS

Although intraventricular schwannomas are rare, 35 cases have already been reported to date. We emphasize the importance of diagnosing such cases correctly to increase knowledge on the origin and pathogenesis of intraventricular tumors, which would facilitate disease management.

摘要

背景

脑室 schwann 瘤极为罕见,文献中迄今仅报道了 35 例。因此,其病因和发病机制尚不清楚,需要进一步研究。在此,我们报告并讨论了一例罕见的脑室 schwann 瘤病例,以阐明这一问题。

病例描述

一名 26 岁男性因头痛和左侧偏盲 1 个月而入院。诊断时,脑部磁共振成像显示右侧侧脑室有一界限清楚的肿块,伴有周围水肿。通过右顶叶经侧裂入路进行了肿瘤全切除。术中观察到肿瘤附着于脉络丛,未侵犯右侧侧脑室壁。各自的组织学检查证实了脑室 schwann 瘤的诊断。手术后 6 个月无复发。此外,在随访期间,患者未出现任何神经功能缺损,包括视野变窄或顶叶症状,如计算障碍、左右、手指和空间失认。

结论

尽管脑室 schwann 瘤很罕见,但迄今已报告了 35 例。我们强调正确诊断此类病例的重要性,以增加对脑室肿瘤起源和发病机制的认识,从而有助于疾病的管理。

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