颅内转移的恶性前庭神经鞘瘤。
Malignant vestibular schwannoma with intracerebral metastasis.
机构信息
Department of Neurosurgery, University Hospital of Wales, Cardiff, United Kingdom of Great Britain and Northern Ireland.
Department of Histopathology, University Hospital Wales, Cardiff, United Kingdom of Great Britain and Northern Ireland.
出版信息
Br J Neurosurg. 2023 Oct;37(5):1354-1357. doi: 10.1080/02688697.2021.1884650. Epub 2021 Mar 9.
BACKGROUND
Malignant change in vestibular schwannoma is rare and intracranial metastatic deposits have not been reported.
CLINICAL PRESENTATION
We report the case of a 64 year old woman with a benign vestibular schwannoma who underwent translabyrinthine excision in 1996 and Gamma Knife radiosurgery (Elekta AB, Stockholm, Sweden) (GKRS) in 2006. She presents 10 years after GKRS with progressive neurological deterioration. Histopathologic analysis confirms a malignant peripheral nerve sheath tumour, WHO grade IV with subsequent metastatic spread to the left thalamus confirmed on biopsy.
CONCLUSION
We report a rare case of a vestibular schwannoma metastasizing with histological confirmation. It also reminds us of malignant conversion of a benign vestibular schwannoma following GKRS and subsequent aggressive behaviour, with poor prognosis.
背景
前庭神经鞘瘤的恶变较为罕见，颅内转移灶尚未见报道。
临床表现
我们报告了一例 64 岁女性患者，1996 年接受经迷路切除术，2006 年接受伽玛刀放射外科治疗（Elekta AB，斯德哥尔摩，瑞典）（GKRS）。在 GKRS 治疗后 10 年，她出现进行性神经功能恶化。组织病理学分析证实为恶性外周神经鞘瘤，WHO 分级 IV，随后活检证实有左侧丘脑转移。
结论
我们报告了一例罕见的前庭神经鞘瘤转移病例，有组织学证实。这也提醒我们，GKRS 后良性前庭神经鞘瘤发生恶性转化，并随后出现侵袭性行为，预后不良。
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