Service de Neurologie Pédiatrique, Hôpital Des Enfants, CHU Toulouse, 330 Avenue de Grande Bretagne, 31059, Toulouse, France.
Service de Réanimation Pédiatrique, Hôpital Des Enfants, CHU Toulouse, Toulouse, France.
BMC Pediatr. 2023 Mar 22;23(1):132. doi: 10.1186/s12887-023-03930-5.
Craniopharyngioma is a rare condition in children, but it is the most frequent tumor that occurs in the hypothalamic pituitary region. Chemical meningitis has been described as an uncommon postoperative complication, but no chemical meningitis due to a spontaneous rupture leading to craniopharyngioma diagnosis in children has been reported.
This is a case of a 13-year-old boy presenting with fever, vomiting and headache for two days. The CT scan revealed a suprasellar lesion, and lumbar puncture showed aseptic meningitis. The cerebral MRI suggested a craniopharyngioma and the cerebrospinal fluid cholesterol concentration was abnormally high. A thorough medical history indicated some visual disturbance, which improved at the onset of meningitis, and an inflection of the growth curve. The anatomopathological analysis of the tumor confirmed the diagnosis of craniopharyngioma.
This case is the first to report the discovery of a craniopharyngioma with meningoencephalitis caused by the rupture of a craniopharyngioma cyst in a child. Diagnosis was facilitated by determining the cholesterol level in the cerebrospinal fluid, as well as fine anamnesis to identify visual and growth disturbances.
颅咽管瘤在儿童中较为罕见，但它是下丘脑-垂体区域最常见的肿瘤。化学性脑膜炎已被描述为一种罕见的术后并发症，但尚无因自发性破裂导致颅咽管瘤诊断而引起的儿童化学性脑膜炎的报道。
这是一例 13 岁男孩，因发热、呕吐和头痛两天就诊。CT 扫描显示鞍上病变，腰椎穿刺显示无菌性脑膜炎。脑 MRI 提示颅咽管瘤，脑脊液胆固醇浓度异常升高。详细的病史提示存在一些视觉障碍，这些障碍在脑膜炎发作时有所改善，且生长曲线出现拐点。肿瘤的解剖病理学分析证实了颅咽管瘤的诊断。
本例是首例报告儿童颅咽管瘤破裂引起脑膜脑炎的病例。通过确定脑脊液中的胆固醇水平，以及详细的病史以识别视觉和生长障碍，有助于诊断。
