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后颅窝岩骨表面硬脑膜来源的神经鞘瘤 1 例罕见病例报告。

A Rare Case of Schwannoma Arising from the Dura Mater of the Petrosal Surface in the Posterior Cranial Fossa.

机构信息

Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.

Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.

出版信息

World Neurosurg. 2020 Sep;141:188-191. doi: 10.1016/j.wneu.2020.06.078. Epub 2020 Jun 20.

Abstract

BACKGROUND

An intracranial schwannoma originating in the dura mater is extremely rare. Herein, we report a case of schwannoma arising from the dura mater of the petrosal surface in the posterior cranial fossa.

CASE DESCRIPTION

A 48-year-old man presented with slight gait disturbance and papilledema. Magnetic resonance imaging showed a T1- and T2-weighted mixed-intensity extra-axial tumor, approximately 4 cm in the maximum diameter with multiple small cysts, in the left posterior cranial fossa. The tumor was heterogeneously enhanced with gadolinium. Operative findings via a lateral suboccipital approach revealed that the tumor did not adhere to any cranial nerves but to the dura mater of the petrosal surface. The tumor was completely excised without any neurologic deficits, and the histologic diagnosis was schwannoma.

CONCLUSIONS

The operative and postoperative findings suggested that the schwannoma originated in the meningeal branch of the lower cranial nerves or upper cervical nerves in the dura mater of the petrosal surface in the posterior cranial fossa.

摘要

背景

起源于硬脑膜的颅内神经鞘瘤极为罕见。本文报告 1 例起源于颅后窝岩骨表面硬脑膜的神经鞘瘤。

病例描述

1 名 48 岁男性以轻微步态障碍和视乳头水肿为主要表现。磁共振成像显示 T1 加权像和 T2 加权像混合强度的颅外肿瘤,最大直径约 4cm,有多个小囊肿,位于左颅后窝。肿瘤不均匀增强伴钆剂强化。通过外侧枕下入路的手术结果显示肿瘤不与任何颅神经相连,而是与岩骨表面硬脑膜相连。肿瘤完全切除,无任何神经功能缺损,组织学诊断为神经鞘瘤。

结论

手术和术后结果提示,该神经鞘瘤起源于颅后窝岩骨表面硬脑膜中的颅神经下部脑膜支或颈神经上部。

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