Khan Nickalus R, Elarjani Turki, Crespo Jolie A, Sargi Zoukaa, Morcos Jacques J
Department of Neurological Surgery, University of Miami, Miami, Florida, USA.
Department of Otolaryngology, University of Miami, Miami, Florida, USA.
Oper Neurosurg. 2021 May 13;20(6):E440-E441. doi: 10.1093/ons/opab013.
We present the case of an 18-yr-old female with 4 mo of progressive vision loss in the left eye. She underwent a computed tomography (CT) and magnetic resonance imaging (MRI), which revealed a large mass in the sphenoid sinus, sella, and anterior cranial fossa. This mass was T1 isointense, with heterogenous enhancement noted on T1 with gadolinium sequences. The mass was found to have calcifications and cystic portions on T2-weighted MRI scans and CT-based imaging. She underwent an endonasal endoscopic approach for resection of the mass. The tumor was found to be bloody, with islands of bone nests within the dura mater of the anterior cranial fossa. The patient improved postoperatively. The pathological diagnosis was found to be the psammomatoid variant of juvenile active ossifying fibroma (JAOF). We present the neuroimaging, anatomic nuances,1 and operative techniques used in this case. We also review the disease background of this rare lesion of the anterior skull base.2-4 The patient gave informed consent for the procedure and verbal consent for the publication of this article.
我们报告了一例18岁女性患者，其左眼渐进性视力丧失4个月。她接受了计算机断层扫描（CT）和磁共振成像（MRI）检查，结果显示蝶窦、鞍区和前颅窝有一个大肿块。该肿块在T1加权像上呈等信号，在T1加权像钆增强序列上可见不均匀强化。在T2加权MRI扫描和基于CT的成像中发现该肿块有钙化和囊性部分。她接受了鼻内镜下肿块切除术。发现肿瘤呈血性，在前颅窝硬脑膜内有骨巢岛。患者术后病情改善。病理诊断为青少年活跃性骨化性纤维瘤（JAOF）的砂粒体样变体。我们展示了该病例的神经影像学、解剖细微差异及手术技巧。我们还回顾了这种罕见的前颅底病变的疾病背景。患者对该手术给予了知情同意，并对本文的发表给予了口头同意。
