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岩斜部胶质瘤误诊为三叉神经鞘瘤:1 例报告。

A petroclival glioma mimicking trigeminal schwannoma: A case report.

机构信息

Department of Radiology, West China Hospital, Sichuan University, 37 Guo Xue Xiang Road, Chengdu, Sichuan, PR China.

Department of Neurosurgery, West China Hospital, Sichuan University, 37 Guo Xue Xiang Road, Chengdu, Sichuan, PR China.

出版信息

Medicine (Baltimore). 2021 Nov 19;100(46):e27792. doi: 10.1097/MD.0000000000027792.

Abstract

RATIONALE

Glioma in the petroclival region is very rare. Also, very few cases of primary gliomas have been reported to have radiographic as well as intraoperative features of extra-axial lesions resulting in diagnostic dilemma in the literature. We present a rare case of petroclival glioma mimicking trigeminal schwannoma in a young female.

PATIENT CONCERNS

We present a 21-years old female with a 3-month history of pain in the right eye with no visual impairment. Cranial nerves examination revealed mild deficits in the trigeminal nerve, facial nerve, auditory nerve, oculomotor as well as the trochlear nerve.

DIAGNOSES

Magnetic resonance imaging detected an extra-axial mass with mixed signal intensities in the right petroclivus area. Immunohistochemical established glioma with world health organization (WHO) grade II.

INTERVENTIONS

The lesion was resected via 2 successive operations in 6 months interval. The patient was further treated with radiotherapy and post-radiotherapy temozolamide.

OUTCOMES

Two years follow-up revealed no recurrence of the lesions and she is well. Nevertheless, he is still being followed diligently to uncover any recurrence.

LESSONS

The extra-axial nature as well as petroclival location of the glioma makes our case very unique and very rare. The imaging characteristics were very extraordinary for a glioma which resulted in diagnostic dilemma. Thus, the definitive diagnosis was based on the histopathological evaluation of the excised tumor.

摘要

背景

岩斜区的脑胶质瘤非常罕见。此外,文献中报道的原发性脑胶质瘤病例很少同时具有轴外病变的影像学和术中特征,导致诊断困难。我们报告了一例罕见的岩斜部脑胶质瘤病例,该病例在年轻女性中表现为三叉神经鞘瘤的特征。

病例描述

我们报告了一例 21 岁女性,3 个月前出现右眼疼痛,无视力障碍。颅神经检查显示三叉神经、面神经、听神经、动眼神经和滑车神经轻度受损。

诊断

磁共振成像显示右侧岩斜区有一个具有混合信号强度的轴外肿块。免疫组化证实为世界卫生组织(WHO)二级胶质瘤。

干预措施

该病变通过 2 次连续手术在 6 个月的间隔内切除。患者进一步接受了放疗和放疗后替莫唑胺治疗。

结果

2 年随访未发现病变复发,患者情况良好。然而,仍在密切随访以发现任何复发。

教训

脑胶质瘤的轴外性质和岩斜区位置使我们的病例非常独特和罕见。影像学特征对于脑胶质瘤来说非常特殊,导致了诊断困难。因此,明确的诊断基于切除肿瘤的组织病理学评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f2e9/8601354/dbdf80015cd5/medi-100-e27792-g001.jpg

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