Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, Gansu, China; Institute of Neurology, Lanzhou University, Lanzhou, Gansu, China.
Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, Gansu, China.
World Neurosurg. 2020 Sep;141:421-424. doi: 10.1016/j.wneu.2020.06.071. Epub 2020 Jun 16.
Dysplastic gangliocytoma is a sporadic cerebellar benign tumor with the characteristics of hamartoma and true tumor, also known as Lhermitte-Duclos disease (LDD). Bone fibrous dysplasia (FD) is a slowly progressive self-limited benign bone tissue disease. Cowden syndrome, an autosomal dominant genetic disorder caused by germline mutations in the PTEN gene, is considered to be closely related to dysplastic gangliocytoma. McCune-Albright syndrome is a disease characterized by café-au-lait skin macules, polyostotic FD, and precocious puberty. The etiologic mechanism of both conditions is not yet clear. We report a rare case of bilateral dysplastic gangliocytoma with concurrent polyostotic FD.
We describe a 16-year-old boy with both LDD and FD. He presented for medical examination with headache and poor eyesight. Magnetic resonance imaging revealed proliferation of the skull and abnormal signals in the cerebellum, and supratentorial hydrocephalus. Subtotal resection of the cerebellar tumor was performed, and the diagnosis of LDD and FD was confirmed by histopathology. No other abnormal changes were found in systemic medical examination and no PTEN gene mutation was found in the genetic analysis; therefore, the diagnoses of Cowden syndrome and McCune-Albright syndrome were excluded.
LDD and FD are 2 rare diseases, and the simultaneous occurrence of the 2 conditions has not been reported before, to our knowledge. Our report challenges the etiology of the 2 diseases and the relationship between them, hoping to provide a reference for the study of the 2 diseases.
错构瘤性神经节细胞瘤是一种散发性小脑良性肿瘤,具有错构瘤和真性肿瘤的特征,又称为 Lhermitte-Duclos 病(LDD)。骨纤维结构不良(FD)是一种进展缓慢、自限性良性骨组织疾病。Cowden 综合征是一种常染色体显性遗传疾病,由 PTEN 基因突变引起,被认为与错构瘤性神经节细胞瘤密切相关。McCune-Albright 综合征是一种以咖啡牛奶斑、多灶性 FD 和性早熟为特征的疾病。这两种疾病的病因机制尚不清楚。我们报告了一例罕见的双侧错构瘤性神经节细胞瘤合并多灶性 FD 的病例。
我们描述了一例 16 岁男孩同时患有 LDD 和 FD。他因头痛和视力不佳就诊。磁共振成像显示颅骨增生和小脑异常信号,以及幕上脑积水。行小脑肿瘤次全切除术,组织病理学诊断为 LDD 和 FD。全身医学检查未发现其他异常改变,基因分析未发现 PTEN 基因突变;因此,排除了 Cowden 综合征和 McCune-Albright 综合征的诊断。
LDD 和 FD 是两种罕见疾病,据我们所知,两者同时发生的情况尚未见报道。我们的报告对这两种疾病的病因和它们之间的关系提出了挑战,希望为这两种疾病的研究提供参考。