Hatae Ryusuke, Mizoguchi Masahiro, Arimura Koichi, Kiyozawa Daisuke, Shimogawa Takafumi, Sangatsuda Yuhei, Nishimura Ataru, Ono Kotaro, Oda Yoshinao, Yoshimoto Koji
Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Surg Neurol Int. 2022 Jul 22;13:314. doi: 10.25259/SNI_422_2022. eCollection 2022.
Angiolipomas are benign mesenchymal tumors comprising mature adipocytes and abnormal blood vessels, commonly found in the subcutaneous tissue of the trunk and rarely in the skull. Furthermore, sporadic cases of angiolipoma with arteriovenous fistula (AVF) have been reported.
We reported the case of a 72-year-old woman who presented with head swelling, seizures, and cognitive dysfunction. Computed tomography and magnetic resonance imaging revealed a right frontal bone tumor exceeding a sagittal suture of up to 10.7 cm. Angiography revealed AVF and varices formation. Endovascular embolization was performed to treat the AVF and reduce blood loss during surgical resection. Two days after the embolization, a craniotomy was performed; however, uncontrollable bleeding was observed at the time of tumor resection. Postoperatively, the patient was symptom-free and has been stable for 2 years without recurrence.
Despite careful preoperative evaluation and treatment planning, the patient in this case report was difficult to treat. Such cases require adequate preparation.
血管脂肪瘤是一种由成熟脂肪细胞和异常血管组成的良性间叶组织肿瘤,常见于躯干皮下组织,很少发生于颅骨。此外,也有散发性血管脂肪瘤伴动静脉瘘(AVF)的病例报道。
我们报告了一例72岁女性患者,她出现头部肿胀、癫痫发作和认知功能障碍。计算机断层扫描和磁共振成像显示右侧额骨肿瘤超过矢状缝达10.7厘米。血管造影显示有动静脉瘘和静脉曲张形成。进行了血管内栓塞治疗动静脉瘘并减少手术切除期间的失血。栓塞术后两天,进行了开颅手术;然而,在肿瘤切除时观察到无法控制的出血。术后,患者无症状,并且已经稳定了2年,无复发。
尽管进行了仔细的术前评估和治疗规划,但本病例报告中的患者治疗困难。此类病例需要充分准备。