局限于前床突的原发性孤立性颅底嗜酸性肉芽肿：病例说明
Primary isolated skull base eosinophilic granuloma confined to the anterior clinoid process: illustrative case.
作者信息
Pour-Rashidi Ahmad, Asem Payam, Abbasioun Kazem, Amirjamshidi Abbas
机构信息
1Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran; and.
2Department of Neurosurgery, Arad Hospital, Tehran, Iran.
出版信息
J Neurosurg Case Lessons. 2022 Jul 18;4(3):CASE22178. doi: 10.3171/CASE22178.
BACKGROUND
Solitary eosinophilic granuloma (EG) occurs anecdotally in the skull base region, and it has been described in only three previous publications. The authors report the first case of EG of the anterior clinoid process (ACP), which was confined to the ACP and presented with decreased vision.
OBSERVATIONS
A 38-year-old woman presented with decreased vision of the left eye of 5 months' duration. Her visual acuity was 3/10, other neurological examinations were intact, and there were no other osseous or soft tissue lesions. The lesion was excised using a left-sided craniotomy and transdural clinoidectomy, decompressing the optic nerve both intra- and extradurally. The lesion was characteristic for EG, and no recurrence was detected after 2 years.
LESSONS
EG can be confined to the ACP and impair vision. Imaging studies are sensitive but not specific, and surgical decompression is both diagnostic and treatment oriented. Close observation and even adjuvant therapy may be indicated in similar cases.
背景
孤立性嗜酸性肉芽肿（EG）偶发于颅底区域，此前仅有三篇相关文献报道。作者报告了首例局限于前床突（ACP）的EG病例，该病例局限于前床突并伴有视力下降。
观察结果
一名38岁女性，左眼视力下降5个月。其视力为3/10，其他神经系统检查正常，且无其他骨质或软组织病变。采用左侧开颅术和经硬膜床突切除术切除病变，对硬膜内和硬膜外的视神经进行减压。该病变具有EG的特征，2年后未发现复发。
经验教训
EG可局限于前床突并损害视力。影像学检查敏感但不具特异性，手术减压兼具诊断和治疗意义。类似病例可能需要密切观察甚至辅助治疗。
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