Guadarrama-Ortiz Parménides, Choreño-García Omar, Capi-Casillas Deyanira, Román-Villagómez Alondra, Alcocer-Villanueva Homero, Almendárez-Sánchez César Adán, Choreño-Parra José Alberto
1Department of Neurosurgery.
2Department of Pathology, Hospital Regional de Alta Especialidad de Zumpango, Zumpango, Estado de México, Mexico; and.
J Neurosurg Case Lessons. 2022 Aug 1;4(5). doi: 10.3171/CASE22249.
Nasal chondromesenchymal hamartomas (NCMHs) are benign, slow-growing lesions formed by mesenchymal and cartilaginous components. They occur predominantly in male infants at the nasopharynx and orbit. Rare cases have been reported in adults. Ectopic NCMHs occurring in other head regions without the typical nasopharyngeal or orbital involvement have not been previously described.
The authors presented the case of a 40-year-old woman with a giant mass in the left frontoparietal region that started to enlarge progressively after the patient's first pregnancy at the age of 21 years. The tumor caused intense headaches, nausea, vomiting, asthenia, and syncope. On admission, the neurological examination revealed no abnormalities. Brain magnetic resonance imaging showed a solid homogeneous tumor without intraaxial involvement extending inferiorly to the left zygomatic arch, with a significant mass effect on the adjacent bones but no infiltration. Remarkably, digital subtraction angiography demonstrated that the tumor received blood supply from superficial as well as intracranial branches of the left vertebral artery. After tumor resection, histopathological analysis revealed characteristics indistinguishable from an NCMH.
The authors described a rare NCMH of the scalp with intracranial blood supply in an adult patient. A case with similar characteristics had not been reported before.
鼻软骨间叶性错构瘤（NCMHs）是由间叶成分和软骨成分形成的良性、生长缓慢的病变。它们主要发生于男婴的鼻咽部和眼眶。成人中罕见病例已有报道。以前尚未描述过发生在其他头部区域、无典型鼻咽部或眼眶受累的异位NCMHs。
作者报告了一例40岁女性病例，其左额顶叶区域有一个巨大肿块，自患者21岁首次怀孕后开始逐渐增大。该肿瘤引起剧烈头痛、恶心、呕吐、乏力和晕厥。入院时，神经系统检查未发现异常。脑部磁共振成像显示一个实性均匀肿瘤，未累及脑内，向下延伸至左颧弓，对相邻骨骼有明显的占位效应，但无浸润。值得注意的是，数字减影血管造影显示该肿瘤接受来自左椎动脉的浅表及颅内分支的血液供应。肿瘤切除后，组织病理学分析显示其特征与NCMH难以区分。
作者描述了一例成年患者中具有颅内血液供应的罕见头皮NCMH。此前尚未报道过具有类似特征的病例。
