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矢状旁脑膜血管外皮细胞瘤/孤立性纤维性肿瘤:两例病例报告及文献综述

Parasagittal meningeal hemangiopericytoma/solitary fibrous tumor: Two case reports and a literature review.

作者信息

Cekov Asen Hristov, Vezirska Donika Ivova, Tzekov Christo Tzekov, Nakov Vladimir Stefanov

机构信息

Department of Neurosurgery, Acibadem City Clinic University Hospital Tokuda, Sofia, Bulgaria.

出版信息

Surg Neurol Int. 2024 Apr 19;15:133. doi: 10.25259/SNI_42_2024. eCollection 2024.

Abstract

BACKGROUND

Solitary fibrous tumor/meningeal hemangiopericytoma (SFT/M-HPC) is a rare neoplasm which accounts for around 1% of the intracranial masses. This pathology has a high risk for recurrence and metastasis to distant locations such as the liver, lungs, and bones. Precise diagnosis necessitates detailed histopathological examination.

CASE DESCRIPTION

We present two case reports of SFT/M-HPC. The first case is a 44-year-old female who presented with headache, nausea, vomiting, and frontal ataxia for several months. Imaging findings showed a large parasagittal extra-axial mass with compression of the frontal horns of both lateral ventricles. She underwent gross total resection with an uncomplicated postoperative period. The patient had no recurrent tumors or distal metastases in the follow-up period of 5 years. The second case is a 48-year-old male who presented with right-sided hemianopsia and hemiparesis. Computed tomography (CT) scans revealed a large parieto-occipital extra-axial mass with superior sagittal sinus engulfment and dislocation of the interhemispheric fissure. He underwent gross total resection with an uncomplicated postoperative period. Six years later, he presented with right-sided weakness. CT scan showed a multifocal recurrent mass at the previous location. He underwent subtotal resection with an uncomplicated postoperative period.

CONCLUSION

SFT/M-HPC should be considered when presented with a meningioma-like tumor mass on preoperative imaging. Immunohistochemical study is crucial for the correct diagnosis. Strict long-term follow-up examinations and regular magnetic resonance imaging scans are key to preventing the appearance of metastases and large recurrent masses.

摘要

背景

孤立性纤维瘤/脑膜血管外皮细胞瘤(SFT/M-HPC)是一种罕见的肿瘤,约占颅内肿瘤的1%。这种病理类型具有较高的复发风险以及远处转移风险,如转移至肝脏、肺和骨骼。精确诊断需要详细的组织病理学检查。

病例描述

我们报告两例SFT/M-HPC病例。第一例是一名44岁女性,数月来出现头痛、恶心、呕吐和额叶共济失调。影像学检查发现矢状窦旁巨大轴外肿块,压迫双侧侧脑室额角。她接受了全切除手术,术后恢复顺利。在5年的随访期内,患者未出现复发性肿瘤或远处转移。第二例是一名48岁男性,出现右侧偏盲和偏瘫。计算机断层扫描(CT)显示顶枕部巨大轴外肿块,累及上矢状窦并使大脑镰移位。他接受了全切除手术,术后恢复顺利。6年后,他出现右侧肢体无力。CT扫描显示原部位有多发复发性肿块。他接受了次全切除手术,术后恢复顺利。

结论

术前影像学检查发现类似脑膜瘤的肿瘤肿块时,应考虑SFT/M-HPC。免疫组织化学研究对正确诊断至关重要。严格的长期随访检查和定期的磁共振成像扫描是预防转移和巨大复发性肿块出现的关键。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/691f/11090575/3543d70b3d0e/SNI-15-133-g001.jpg

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