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颅骨底部伴有硬脑膜侵犯的婴儿Kaposiform 血管内皮细胞瘤:1 例报告。

Kaposiform hemangioendothelioma of skull base with dura invasion in a pediatric patient: a case report.

机构信息

Department of Neurosurgery, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea.

Department of Pediatrics, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Hwasun, Republic of Korea.

出版信息

Childs Nerv Syst. 2023 Nov;39(11):3289-3294. doi: 10.1007/s00381-023-06025-9. Epub 2023 Jun 24.

Abstract

Kaposiform hemangioendothelioma is an extremely rare vascular tumor which shows aggressive local growth. We present a case of rapid growing vascular skull tumor with dura invasion in a pediatric patient with neurofibromatosis type 1. A 14-year-old male complained of headache and dizziness for 1 month after minor head trauma. Brain magnetic resonance imaging (MRI) revealed a 5-cm-sized tumor in the left frontotemporal bone with internal hemorrhage and cystic changes. The gross total resection of tumor was done. At the 7-month follow-up, brain MRI revealed a recurrent skull tumor with intracranial dura mass. He underwent second surgery, and the pathologic diagnosis was suggestive of Kaposiform hemangioendothelioma. For this vascular proliferative tumor, mTOR inhibitor was treated for 6 months, and there was the recurred nodular-enhancing mass along the sphenoid ridge. After additional 2 months of medication, the following MRI revealed a decreased nodular-enhancing mass.

摘要

颅外型血管外皮细胞瘤是一种极其罕见的血管肿瘤,具有侵袭性局部生长的特点。我们报告 1 例伴有神经纤维瘤病 1 型的儿童快速生长的伴硬脑膜侵犯的颅血管肿瘤。14 岁男性患者轻微头部外伤后 1 个月出现头痛和头晕。脑部磁共振成像(MRI)显示左额颞骨 5cm 大小的肿瘤,伴内部出血和囊性变。行肿瘤全切除。7 个月后随访时,脑部 MRI 显示颅骨肿瘤复发性颅内硬脑膜肿块。患者行二次手术,病理诊断为颅外型血管外皮细胞瘤。对于这种血管增生性肿瘤,使用 mTOR 抑制剂治疗 6 个月后,蝶骨嵴处出现复发性结节增强肿块。加用药物治疗 2 个月后,MRI 显示结节增强肿块缩小。

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