Li Li, Ying Guang-Yu, Tang Ya-Juan, Wu Hemmings
Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China.
World J Clin Cases. 2021 Mar 16;9(8):1863-1870. doi: 10.12998/wjcc.v9.i8.1863.
Intradural osteoma is very rarely located in the subdural or subarachnoid space. Unfortunately, intradural osteoma lacks specificity in clinical manifestations and imaging features and there is currently no consensus on its diagnosis method or treatment strategy. Moreover, the pathogenesis of osteoma without skull structure involvement remains unclear.
We describe two cases of intradural osteomas located in the subdural and subarachnoid spaces, respectively. The first case involved a 47-year-old woman who presented with a 3-year history of intermittent headache and dizziness. Intraoperatively, a bony hard mass was found in the left frontal area, attached to the inner surface of the dura mater and compressing the underlying arachnoid membrane and brain. The second case involved a 56-year-old woman who had an intracranial high-density lesion isolated under the right greater wing of the sphenoid. Intraoperatively, an arachnoid-covered bony tumor was found in the sylvian fissure. The pathological diagnosis for both patients was osteoma.
Surgery and pathological examination are required for diagnosis of intradural osteomas, and craniotomy is a safe and effective treatment.
硬脊膜内骨瘤极少位于硬脑膜下或蛛网膜下腔。遗憾的是，硬脊膜内骨瘤在临床表现和影像学特征方面缺乏特异性，目前对于其诊断方法或治疗策略尚无共识。此外，不累及颅骨结构的骨瘤发病机制仍不清楚。
我们分别描述了两例位于硬脑膜下和蛛网膜下腔的硬脊膜内骨瘤病例。第一例为一名47岁女性，有3年间歇性头痛和头晕病史。术中，在左额叶区域发现一个骨质坚硬的肿块，附着于硬脑膜内表面，压迫下方的蛛网膜和脑。第二例为一名56岁女性，在右侧蝶骨大翼下方发现一个孤立的颅内高密度病变。术中，在外侧裂发现一个被蛛网膜覆盖的骨肿瘤。两名患者的病理诊断均为骨瘤。
硬脊膜内骨瘤的诊断需要手术及病理检查，开颅手术是一种安全有效的治疗方法。
