Ordookhanian Christ, Amidon Ryan F, Vartanian Talia, Kaloostian Paul
Medicine, University of California, Riverside, USA.
Neuroscience, University of California, Riverside, USA.
Cureus. 2020 Apr 21;12(4):e7754. doi: 10.7759/cureus.7754.
Meningiomas are the most common benign intracranial tumors. They often require surgical resection and postoperative radiation/chemotherapy based on their histologic grade. While necrosis caused by preoperative embolization and spontaneous tumor infarction is appreciated by pathologists when staging meningiomas, intraoperative events including large bore artery occlusion may also alter the histopathologic picture of a benign meningioma. Hence, they should be considered when signs of unexpected ischemia and necrosis are found, as these same phenotypes are also hallmarks of a higher-grade disease. We describe a case of a man with a large ventral foramen magnum meningioma who underwent temporary intraoperative occlusion of the vertebral artery, leading to ischemic tumor necrosis with abundant neutrophil invasion when the tumor was eventually examined histologically.
脑膜瘤是最常见的颅内良性肿瘤。根据其组织学分级，它们通常需要手术切除以及术后放疗/化疗。虽然病理学家在对脑膜瘤进行分期时能够识别术前栓塞和自发性肿瘤梗死引起的坏死，但包括大口径动脉闭塞在内的术中情况也可能改变良性脑膜瘤的组织病理学表现。因此，当发现意外缺血和坏死迹象时应予以考虑，因为这些相同的表型也是高级别疾病的特征。我们描述了一例患有大型枕骨大孔腹侧脑膜瘤的男性病例，该患者在术中接受了椎动脉临时闭塞，最终对肿瘤进行组织学检查时发现肿瘤出现缺血性坏死并伴有大量中性粒细胞浸润。
