Department of Neurosurgery, The Second Affiliated Hospital of Anhui Medical University, Cerebral Vascular Disease Research Centre, Anhui Medical University, Hefei, China.
Int J Neurosci. 2023 Apr;133(4):450-456. doi: 10.1080/00207454.2021.1929209. Epub 2022 May 23.
PURPOSE/AIM: Cerebellopontine angle (CPA) oligodendrogliomas are very rare, and only three preoperative cases have been confirmed. Secondary CPA oligodendrogliomas after radiation therapy are exceptionally rare, and no other cases have been reported.
We present a case of a 25-year-old male with CPA oligodendroglioma who experienced hearing loss in right ear with walking instability for more than 2 months. The patient underwent craniotomy in our hospital because of grade II astrocytoma of the right temporal lobe 10 years ago. Postoperative radiotherapy lasted for 30 days, and six rounds of chemotherapy were performed. Magnetic resonance imaging (MRI) of the head revealed a cystic lesion located in the right CPA. The patient underwent surgery without obvious complications, and the tumor was subtotally removed. Histopathological examination revealed a diagnosis of oligodendroglioma, World Health Organization (WHO) grade II. The patient was discharged on the tenth postoperative day with a good recovery. Two weeks after discharge, chemotherapy with temozolomide and radiotherapy were performed. The patient remained well at 8 months follow-up.
To the best of our knowledge, no other cases of secondary CPA oligodendroglioma after cranial irradiation have been reported in the literature. Compared with general oligodendroglioma, the tumor has no typical calcification and is more aggressive. The cranial nerves in the CPA area are closely adhered, and the blood supply is abnormally rich. It is difficult to completely remove the tumor. Postoperative radiotherapy and chemotherapy should be carried out as soon as possible.
目的/目标：桥小脑角（CPA）少突胶质细胞瘤非常罕见，仅有 3 例术前确诊病例。放疗后发生的继发性 CPA 少突胶质细胞瘤极为罕见，目前尚无其他病例报告。
我们报告了 1 例 25 岁男性患者，因右耳听力丧失伴行走不稳超过 2 个月就诊。该患者 10 年前因右侧颞叶 II 级星形细胞瘤在我院行开颅手术，术后行 30 天放疗和 6 个疗程化疗。头部磁共振成像（MRI）显示右侧 CPA 存在囊性病变。患者接受了手术治疗，无明显并发症，肿瘤大部分切除。组织病理学检查提示为少突胶质细胞瘤，世界卫生组织（WHO）分级 II 级。术后第 10 天患者顺利出院，恢复良好。出院后 2 周行替莫唑胺化疗和放疗。患者在 8 个月的随访中情况良好。
据我们所知，文献中尚无其他颅照射后继发性 CPA 少突胶质细胞瘤的报道。与一般的少突胶质细胞瘤相比，该肿瘤没有典型的钙化，侵袭性更强。CPA 区域的脑神经紧密相连，血供异常丰富，难以完全切除肿瘤。术后应尽快行放疗和化疗。
