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并发多发性脑海绵状血管畸形和马尾副神经节瘤:病例说明

Concurrent multiple cerebral cavernous malformations and cauda equina paraganglioma: illustrative case.

作者信息

Liu Daniel, Rodriguez Michael, Ross Dominic, Ghahreman Ali

机构信息

Departments of Neurosurgery, St George Hospital, Kogarah, New South Wales, Australia.

Douglass Hanly Moir Pathology, Macquarie Park, New South Wales, Australia.

出版信息

J Neurosurg Case Lessons. 2024 Aug 5;8(6). doi: 10.3171/CASE24102.

Abstract

BACKGROUND

Cauda equina neuroendocrine tumors (CENETs), previously known as cauda equina paragangliomas, and multiple cerebral cavernous malformations (CCMs) are uncommon conditions affecting the central nervous system. To the authors' knowledge, they have not been reported in the same patient.

OBSERVATIONS

The authors present the case of a 45-year-old male with CENET and concurrent incidental MRI findings of multiple CCMs. Familial CCMs are associated with mutations in the KRIT1 (CCM1), MGC4607 (CCM2), and PDCD10 (CCM3) genes. Peripheral paragangliomas have been associated with mutations in succinate dehydrogenase (SDHx), RET (multiple endocrine neoplasia 2), VHL (von Hippel-Lindau syndrome), and NF1 (neurofibromatosis type 1) genes. Except for a single case, cauda equina paragangliomas have not been associated with any underlying genetic mutations.

LESSONS

It is unclear whether the co-occurrence of these two rare conditions in the same patient is coincidental or suggests a possible shared pathogenesis. https://thejns.org/doi/10.3171/CASE24102.

摘要

背景

马尾神经内分泌肿瘤(CENETs),以前称为马尾副神经节瘤,以及多发性脑海绵状血管畸形(CCMs)是影响中枢神经系统的罕见病症。据作者所知,尚未有同一患者同时出现这两种病症的报道。

观察结果

作者报告了一例45岁男性患者,患有马尾神经内分泌肿瘤,同时MRI偶然发现多发性脑海绵状血管畸形。家族性脑海绵状血管畸形与KRIT1(CCM1)、MGC4607(CCM2)和PDCD10(CCM3)基因突变有关。外周副神经节瘤与琥珀酸脱氢酶(SDHx)、RET(多发性内分泌肿瘤2型)、VHL(冯·希佩尔-林道综合征)和NF1(1型神经纤维瘤病)基因突变有关。除了一例病例外,马尾副神经节瘤尚未与任何潜在的基因突变相关联。

经验教训

尚不清楚这两种罕见病症在同一患者中同时出现是巧合还是提示可能存在共同的发病机制。https://thejns.org/doi/10.3171/CASE24102。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e5d/11301588/ddae56bd30ec/CASE24102_figure_1.jpg

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