Department of Neurology, First Hospital of Jilin University, Chang Chun, China.
Department of Oncological Neurosurgery, First Hospital of Jilin University, Chang Chun, China.
Medicine (Baltimore). 2022 Sep 9;101(36):e30492. doi: 10.1097/MD.0000000000030492.
Dandy-Walker complex and pleomorphic xanthoastrocytomas are both rare disease entities that typically manifest early in life and are associated with congenital etiological factors. Dandy-Walker complex is a cerebellar malformation associated with a series of anatomical changes. The disease onset is usually at birth or during infancy. Late onset in adulthood is uncommon. Pleomorphic xanthoastrocytoma is a rare WHO grade II astrocytic tumor affecting mainly young adults. Concomitant occurrence of Dandy-Walker complex and pleomorphic xanthoastrocytoma has not been previously reported.
A 30-year-old woman with a previous history of unconfirmed resected lateral ventricle meningioma presented with severe headache for 1 day. Imaging examination revealed a mass in the right lateral ventricle with heterogeneous signal patterns, changes in the posterior fossa corresponding to a Dandy-Walker variant, and mild hydrocephalus.
Surgical complete resection of the mass was achieved. postoperative histopathological examination confirmed WHO grade II pleomorphic xanthoastrocytoma. Three years postsurgery, ventriculoperitoneal shunt was performed due to worsening of hydrocephalus. The patient has since remained symptom-free.
This is the first report of concomitant occurrence of Dandy-Walker complex and pleomorphic xanthoastrocytoma. The association of neurological congenital malformation with intracranial neoplasms may be multifactorial, with underlying role of genetic mutations or chromosome alterations.
Dandy-Walker 综合征和多形性黄色星形细胞瘤都是罕见的疾病实体,通常在生命早期出现,并与先天性病因因素有关。Dandy-Walker 综合征是一种与一系列解剖结构变化相关的小脑畸形。疾病发作通常在出生时或婴儿期。成年人晚期发病罕见。多形性黄色星形细胞瘤是一种罕见的 WHO 二级星形细胞瘤,主要影响年轻人。Dandy-Walker 综合征和多形性黄色星形细胞瘤同时发生的情况以前尚未报道过。
一名 30 岁女性,有未确诊的侧脑室脑膜瘤切除史,因严重头痛 1 天就诊。影像学检查显示右侧侧脑室有一肿块,信号不均,后颅窝相应部位为 Dandy-Walker 变异型,伴有轻度脑积水。
手术实现了肿块的完全切除。术后组织病理学检查证实为 WHO 二级多形性黄色星形细胞瘤。术后 3 年,由于脑积水加重,行脑室-腹腔分流术。此后,患者一直无症状。
这是 Dandy-Walker 综合征和多形性黄色星形细胞瘤同时发生的首例报告。神经发育性先天性畸形与颅内肿瘤的关联可能是多因素的,潜在的遗传突变或染色体改变起作用。