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原发性颅内肉瘤伪装为慢性硬脑膜下血肿:一个罕见现象的病例报告和文献复习。

Primary intracranial sarcoma masquerading as a chronic subdural haematoma: illustrative case and review of an unusual phenomenon.

机构信息

Department of Neurosurgery, Sri Sathya Sai Institute of Higher Medical Sciences, Whitefield, ITPL Main Road, Bangalore, 560066, Karnataka, India.

出版信息

Childs Nerv Syst. 2023 Jul;39(7):1957-1962. doi: 10.1007/s00381-023-05919-y. Epub 2023 Mar 18.

DOI:10.1007/s00381-023-05919-y
PMID:36932253
Abstract

It is very unusual for a primary intracranial malignancy to present as a chronic subdural hematoma. This case report describes one such case in a 3-year-old girl who presented with raised intracranial pressure following a mild head injury. Imaging of her brain revealed bilateral chronic subdural hematomas with an enhancing subdural mass and multiple nodular lesions infiltrating the brain parenchyma. She underwent a craniotomy, drainage of the subdural collections and resection of the subdural mass. Histopathology revealed an undifferentiated sarcoma, and she was referred for adjuvant therapy. This case underlines the importance of evaluating paediatric subdural collections for a possible underlying malignancy, even in the background of a preceding head injury. The cause-effect relationship of sarcomas with subdural collections remains unclear because of the scarcity of available literature on the subject.

摘要

原发性颅内恶性肿瘤以慢性硬膜下血肿为首发表现的情况非常罕见。本病例报告描述了一例 3 岁女孩的病例,该患者在轻度头部外伤后出现颅内压升高。其脑部影像学检查显示双侧慢性硬膜下血肿,伴有硬膜下肿块增强和多个结节状病变浸润脑实质。她接受了开颅手术、硬膜下血肿引流和硬膜下肿块切除术。组织病理学显示为未分化肉瘤,随后她被转介接受辅助治疗。本病例强调了即使在先前头部外伤的背景下,也应对小儿硬膜下积液进行可能潜在恶性肿瘤的评估。由于关于该主题的可用文献有限,肉瘤与硬膜下积液之间的因果关系尚不清楚。

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Primary intracranial sarcoma masquerading as a chronic subdural haematoma: illustrative case and review of an unusual phenomenon.原发性颅内肉瘤伪装为慢性硬脑膜下血肿:一个罕见现象的病例报告和文献复习。
Childs Nerv Syst. 2023 Jul;39(7):1957-1962. doi: 10.1007/s00381-023-05919-y. Epub 2023 Mar 18.
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本文引用的文献

1
Primary intracranial soft tissue sarcomas in children, adolescents, and young adults: single institution experience and review of the literature.儿童、青少年及年轻成人原发性颅内软组织肉瘤:单机构经验及文献综述
J Neurooncol. 2016 Mar;127(1):155-63. doi: 10.1007/s11060-015-2027-3. Epub 2015 Dec 30.
2
Successful treatment of primary intracranial sarcoma with the ICE chemotherapy regimen and focal radiation in children.采用ICE化疗方案及局部放疗成功治疗儿童原发性颅内肉瘤。
J Neurosurg Pediatr. 2016 Mar;17(3):298-302. doi: 10.3171/2015.6.PEDS14709. Epub 2015 Nov 20.
3
Subdural Metastasis of Prostate Cancer.
前列腺癌的硬脑膜下转移
J Neurol Surg Rep. 2015 Jul;76(1):e123-7. doi: 10.1055/s-0035-1549224. Epub 2015 May 13.
4
Chronic subdural hematoma associated with subdural rhabdomyosarcoma: case report.慢性硬膜下血肿合并硬膜下横纹肌肉瘤:病例报告
Neurosurgery. 2007 Apr;60(4):E774-5; discussion E775. doi: 10.1227/01.NEU.0000255403.30904.00.
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Primary central nervous system sarcomas in children: clinical, radiological, and pathological features.儿童原发性中枢神经系统肉瘤:临床、影像学及病理特征
Childs Nerv Syst. 2003 Dec;19(12):808-17. doi: 10.1007/s00381-003-0839-5. Epub 2003 Oct 22.
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Subdural sarcoma associated with chronic subdural hematoma. Report of two cases and review of the literature.与慢性硬膜下血肿相关的硬膜下肉瘤。两例报告并文献复习。
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Intracranial primary nonlymphomatous sarcomas in children: experience with eight cases and review of the literature.儿童颅内原发性非淋巴瘤性肉瘤:8例经验及文献复习
Neurosurgery. 1984 May;14(5):529-40. doi: 10.1227/00006123-198405000-00001.
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[Subdural effusion as a sequela of diffuse leptomeningeal sarcoma].[硬膜下积液作为弥漫性柔脑膜肉瘤的后遗症]
Neurochirurgia (Stuttg). 1972 Nov;15(6):227-31. doi: 10.1055/s-0028-1090547.