John Albin A, Marsh Harrison, Rossettie Stephen S, Ray Coby N, Freedman Kenn A, Baronia Benedicto C
Departments of1Surgery.
2Ophthalmology, and.
J Neurosurg Case Lessons. 2022 Feb 7;3(6). doi: 10.3171/CASE21544.
Craniopharyngiomas are uncommon malformations of the sellar or parasellar region that are partly cystic and calcified and have low histological grade. The typical age of presentation is bimodal, with peak incidence rates in children at age 5 to 14 years and in adults at age 50 to 74 years. The usual clinical manifestations are related to endocrine deficiencies due to mass effect along with visual impairment and increased intracranial pressure. If a tumor is favorably localized, the treatment of choice is complete resection.
The authors presented a unique case of a 61-year-old man with a suspicious cystic lesion in the right orbital roof that was causing right-sided headaches with pressure and pain in the right eye. Both computed tomography and magnetic resonance imaging were used for further evaluation and showed a suspicious lytic bone lesion that had an epicenter within the orbital rim, which was highly suggestive of a tumor of interosseous origin. After removal, the tumor was identified by pathology as a craniopharyngioma.
The importance of this case report is in documenting a unique case of an ectopic craniopharyngioma in the orbit, adding to current hypotheses of the pathogenesis of ectopic craniopharyngiomas, and presenting an extensive review of literature.
颅咽管瘤是鞍区或鞍旁区域少见的畸形,部分为囊性且伴有钙化,组织学分级较低。典型的发病年龄呈双峰分布,5至14岁儿童及50至74岁成人发病率最高。常见临床表现与因占位效应导致的内分泌功能缺陷、视力损害及颅内压升高有关。若肿瘤定位良好,首选治疗方法是完整切除。
作者报告了一例独特病例,一名61岁男性,右侧眶顶有一可疑囊性病变,导致右侧头痛并伴有右眼压痛。计算机断层扫描和磁共振成像均用于进一步评估,结果显示一可疑溶骨性骨病变,其中心位于眶缘内,高度提示为骨间源性肿瘤。切除后,经病理检查确定该肿瘤为颅咽管瘤。
本病例报告的重要性在于记录了一例眶内异位颅咽管瘤的独特病例,丰富了目前关于异位颅咽管瘤发病机制的假说,并对文献进行了广泛综述。