Yip Chi-Man, Jan Chia Ing
Division of Neurosurgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Department of Pathology and Laboratory Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
J Neurol Surg Rep. 2024 Dec 5;85(4):e179-e183. doi: 10.1055/a-2466-7362. eCollection 2024 Oct.
Gliomas and meningiomas are two common primary brain tumors, but occurring simultaneously in the same patient is a rare entity. The authors would like to report a case of coexistence of a superior parietal lobule diffuse glioma, IDH-wild type, histologically CNS WHO grade 3 and a left posterior fossa transitional meningioma, WHO grade 1; both the tumors were successfully removed in one-stage operation. A 68-year-old female having hypertension, who presented to us with the chief complaints of involuntary shaking of her left lower limb associated with her left upper limb tingle, dizziness, and neck soreness. She was found to have a lesion in her right parietal region and a tumor in her left cerebellar region. After detailed discussion with the patient and thorough preoperative evaluation, the authors performed a right parietal craniotomy and a left retrosigmoid approach in one-stage operation to remove both the tumors, which were proven to be of two distinct histological identities. The management for two tumors located far apart needs a case-by-case evaluation. An important aspect while dealing with such cases is to decide which tumor needs to be operated first or whether both lesions can be operated at the same time with one-stage operation.
胶质瘤和脑膜瘤是两种常见的原发性脑肿瘤,但在同一患者中同时发生是一种罕见的情况。作者报告一例顶叶上部弥漫性胶质瘤(异柠檬酸脱氢酶野生型,组织学上为世界卫生组织中枢神经系统3级)与左后颅窝过渡型脑膜瘤(世界卫生组织1级)共存的病例;两个肿瘤均在一期手术中成功切除。
一名68岁患有高血压的女性前来就诊,主要症状为左下肢不自主抖动伴左上肢刺痛、头晕和颈部酸痛。发现她右侧顶叶区域有一个病变,左侧小脑区域有一个肿瘤。在与患者进行详细讨论并进行全面的术前评估后,作者在一期手术中采用了右侧顶叶开颅术和左侧乙状窦后入路来切除这两个肿瘤,术后证实这两个肿瘤具有两种不同的组织学特征。
对于两个相距较远的肿瘤的处理需要逐案评估。处理此类病例时的一个重要方面是决定先切除哪个肿瘤,或者两个病变是否可以在一期手术中同时切除。