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以鞍区肿块为表现的转移性脉络丛乳头状瘤:一例报告及文献复习

Metastatic choroid plexus papilloma presenting as a sellar mass: A case report and literature review.

作者信息

Wilkinson Brandon Michael, Duncan Michael A, Draytsel Dan Y, Babu Harish

机构信息

Department of Neurosurgery, State University of New York (SUNY) Upstate Medical University, Syracuse, New York, United States.

出版信息

Surg Neurol Int. 2024 Apr 19;15:140. doi: 10.25259/SNI_847_2023. eCollection 2024.

Abstract

BACKGROUND

Choroid plexus papillomas (CPPs) are rare neoplasms arising from choroid plexus epithelium representing <1% of all intracranial tumors. Symptoms vary based on location and regional mass effect; however, hydrocephalus is common due to cerebrospinal fluid flow obstruction and/or overproduction. Distant site metastasis or formation in extraventricular sites is rare.

CASE DESCRIPTION

A 57-year-old female with a history of a 4 ventricular CPP status post resection in 2004 and 2018 with subsequent gamma knife therapy in 2019 presented with increased thirst and urination. Since her initial surgery, she has experienced significant gait imbalance, diplopia, dysphagia, and right-sided hemiparesis and hemisensory loss. Magnetic resonance imaging revealed a new 1.5 × 1.8 cm suprasellar lesion. She underwent a left supraorbital craniotomy for tumor resection, with pathology revealing metastatic World Health Organization grade II CPP.

CONCLUSION

Extraventricular manifestation of CPP is rare. or metastatic involvement of the sella has seldom been reported. Treatment should target gross total surgical resection. Adjuvant chemotherapy and radiation may be useful in higher-grade lesions.

摘要

背景

脉络丛乳头状瘤(CPPs)是起源于脉络丛上皮的罕见肿瘤,占所有颅内肿瘤的比例不到1%。症状因位置和局部占位效应而异;然而,由于脑脊液流动受阻和/或分泌过多,脑积水很常见。远处转移或在脑室外部位形成很少见。

病例描述

一名57岁女性,有4脑室CPP病史,分别于2004年和2018年接受手术切除,随后于2019年接受伽玛刀治疗,现出现口渴和多尿症状。自初次手术后,她出现明显的步态失衡、复视、吞咽困难、右侧偏瘫和半侧感觉丧失。磁共振成像显示鞍上有一个新的1.5×1.8 cm病变。她接受了左眶上开颅肿瘤切除术,病理显示为世界卫生组织II级转移性CPP。

结论

CPP的脑室外表现罕见。鞍区转移受累很少有报道。治疗应针对肿瘤全切术。辅助化疗和放疗可能对高级别病变有用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc1d/11090562/70ef62314bb9/SNI-15-140-g001.jpg

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