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右侧小脑发育异常性神经节细胞瘤:病例报告及文献复习

Dysplastic ganglion cell tumor of the right cerebellum: A case report and literature review.

作者信息

Wang Shilong, Li Jun, Dong Jiangtao, Wang Ganggang, Xu Haoxiang, Zhu Licang, Xu Hui

机构信息

Department of Neurosurgery, The First Affiliated Hospital of Shihezi University, Shihezi, China.

Department of Dermatology, The First Affiliated Hospital of Shihezi University, Shihezi, China.

出版信息

Medicine (Baltimore). 2024 Dec 13;103(50):e40990. doi: 10.1097/MD.0000000000040990.

DOI:10.1097/MD.0000000000040990
PMID:39686423
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11651450/
Abstract

RATIONALE

This study aims to present a case of cerebellar dysplastic ganglioneuroma, which is commonly referred to as Lhermitte-Duclos disease (LDD). Furthermore, the study aims to provide an extensive review of the essential aspects of LDD, thereby providing essential information for its accurate diagnosis and effective treatment.

PATIENT CONCERNS

A 54-year-old woman was admitted with symptoms of headache, facial numbness, and a visible cerebellar mass. Imaging studies revealed specific features such as the "tiger stripe sign" on magnetic resonance imaging, including hydrocephalus compression and abnormal vasculature.

DIAGNOSES

The diagnosis of LDD was made.

INTERVENTIONS

The cerebellar mass was resected via a paracentral approach.

OUTCOMES

The patient underwent surgery for a cerebellar dysplastic ganglion cell tumor (WHO grade I), confirmed by postoperative pathology. Despite sub-complete resection with minor residuals, the patient experienced significant improvement in symptoms. A postoperative computed tomography scan revealed a large cavity with frontal lobe hemorrhage. PTEN gene testing was recommended but declined due to financial constraints. The patient was discharged without complications.

LESSONS

LDD presents both benign and tumor characteristics, with a low likelihood of malignancy. Total resection is the recommended treatment, although challenges in complete excision may lead to recurrence. The importance of considering Cowden syndrome and genetic testing, particularly the PTEN gene, in patients with LDD, is emphasized. Long-term follow-up care is crucial for monitoring recurrence and related conditions.

摘要

原理

本研究旨在报告一例小脑发育异常性神经节细胞瘤,即通常所说的勒米特-迪克洛病(LDD)。此外,该研究旨在对LDD的基本方面进行广泛综述,从而为其准确诊断和有效治疗提供重要信息。

患者情况

一名54岁女性因头痛、面部麻木及可见的小脑肿块症状入院。影像学检查显示出特定特征,如磁共振成像上的“虎纹征”,包括脑积水压迫和异常血管。

诊断

确诊为LDD。

干预措施

通过中央旁入路切除小脑肿块。

结果

患者接受了小脑发育异常性神经节细胞瘤(世界卫生组织I级)手术,术后病理证实。尽管次全切除有少量残留,但患者症状有显著改善。术后计算机断层扫描显示有一个伴有额叶出血的大腔隙。建议进行PTEN基因检测,但因经济限制被拒绝。患者无并发症出院。

经验教训

LDD兼具良性和肿瘤特征,恶变可能性低。推荐全切除治疗,尽管完全切除存在挑战可能导致复发。强调了在LDD患者中考虑考登综合征和基因检测,特别是PTEN基因检测的重要性。长期随访护理对于监测复发及相关情况至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19c1/11651450/00a976a28e9a/medi-103-e40990-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19c1/11651450/a04fcefadc9b/medi-103-e40990-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19c1/11651450/760346975605/medi-103-e40990-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19c1/11651450/00a976a28e9a/medi-103-e40990-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19c1/11651450/a04fcefadc9b/medi-103-e40990-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19c1/11651450/760346975605/medi-103-e40990-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19c1/11651450/00a976a28e9a/medi-103-e40990-g003.jpg

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