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中枢神经系统内胚层囊肿:文献综述及病例报告

Endodermal Cysts of the Central Nervous System: Review of the Literature and a Case Report.

作者信息

Kalfas Fotios, Scudieri Claudia

机构信息

Department of Neurosurgery Padua University Hospital, Padua, Italy.

Department of Neurosurgery and Gamma Knife Radiosurgery, IRCCS San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy.

出版信息

Asian J Neurosurg. 2020 Dec 21;15(4):989-996. doi: 10.4103/ajns.AJNS_322_19. eCollection 2020 Oct-Dec.

Abstract

CONTEXT

Endodermal cysts are rare benign developmental cysts lined by mucin-secreting and/or ciliated, cuboidal, or columnar epithelium of probably endodermal origin.

AIMS

Endodermal cysts are rarely intracranial, frequently located in the posterior fossa. Supratentorial location is the most infrequent and only few cases are reported in the literature, included our case.

SETTINGS AND DESIGN

The authors report a case of intracranial supratentorial endodermal cyst with a review of the literature.

SUBJECTS AND METHODS

A 40-year-old woman was admitted to our department because of progressive gait disorder for 3 months due to right brachial and crural motor deficit associated to right crural sensory disorder (tactile hypesthesia) and right Babinski response at neurological examination due to an endodermal cyst located in the left frontoparietal convexity.

DISCUSSION

Total resection of endodermal cysts is recommended, despite their location and adhesion to the surrounding structures, due to its high risk of recurrence. Fenestration of the cystic content into the subarachnoid cistern may cause obstructive hydrocephalus or chemical meningism.

RESULTS

Although rare, surgeons should be aware that these lesions must be differentiated clinically, radiologically, and histologically from other supratentorial cystic lesions.

摘要

背景

内胚层囊肿是一种罕见的良性发育性囊肿,内衬可能起源于内胚层的分泌粘蛋白和/或有纤毛的立方上皮或柱状上皮。

目的

内胚层囊肿很少位于颅内,常位于后颅窝。幕上位置最为罕见,文献中仅报道了少数病例,包括我们的病例。

背景与设计

作者报告了一例幕上颅内内胚层囊肿病例,并对文献进行了综述。

研究对象与方法

一名40岁女性因进行性步态障碍3个月入院,该步态障碍是由于位于左额顶叶凸面的内胚层囊肿导致右侧臂部和腿部运动功能障碍,伴有右侧腿部感觉障碍(触觉减退)以及神经系统检查时右侧巴宾斯基征阳性。

讨论

尽管内胚层囊肿位置特殊且与周围结构粘连,但因其复发风险高,建议进行全切除。将囊肿内容物引流至蛛网膜下腔可能会导致梗阻性脑积水或化学性脑膜炎。

结果

尽管罕见,但外科医生应意识到,必须在临床、影像学和组织学上对这些病变与其他幕上囊性病变进行鉴别。

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