Xie Tao, Zhang Xiaobiao
1Department of Neurosurgery, Zhongshan Hospital, Fudan University, Shanghai, China.
3Cancer Center, Shanghai Zhongshan Hospital, Fudan University, Shanghai, China.
J Neurosurg Case Lessons. 2022 Aug 15;4(7). doi: 10.3171/CASE22166.
Craniopharyngiomas that rarely extend into the posterior fossa are treated with staged operations or combined approaches. The authors reported a patient undergoing gross-total resection of a suprasellar with recurrent cerebellopontine angle (CPA) craniopharyngioma using an endoscopic far-lateral supracerebellar infratentorial approach (EFL-SCITA).
The patient was a 15-year-old boy who presented with headache and decreased vision that lasted for half a year. He previously received three surgeries related to CPA craniopharyngioma. Preoperative magnetic resonance imaging revealed a suprasellar with recurrent CPA craniopharyngioma. Gross-total resection of this suprasellar and CPA tumor was achieved through EFL-SCITA. All symptoms and signs were improved. There were no postsurgical complications except for mild facial paralysis.
EFL-SCITA can be used not only for tumors in the posterolateral pontomesencephalon and ptero-clival-tentorial area but also for tumors in the suprasellar region with posterior fossa extension.
很少延伸至后颅窝的颅咽管瘤采用分期手术或联合手术方法治疗。作者报告了1例患者,采用内镜远外侧小脑上幕下入路(EFL-SCITA)对1例鞍上复发伴小脑脑桥角(CPA)颅咽管瘤进行了全切除。
该患者为一名15岁男孩,出现头痛和视力下降半年。他之前接受过3次与CPA颅咽管瘤相关的手术。术前磁共振成像显示鞍上复发CPA颅咽管瘤。通过EFL-SCITA实现了该鞍上和CPA肿瘤的全切除。所有症状和体征均得到改善。除轻度面瘫外,无术后并发症。
EFL-SCITA不仅可用于脑桥中脑外侧和翼突-斜坡-幕区的肿瘤,也可用于延伸至后颅窝的鞍上区肿瘤。