Harada K, Hayashi T, Anegawa S, Torigoe R, Maeda K, Toda K, Sugita Y, Utsunomiya H
Department of Neurosurgery, St. Mary's Hospital, Fukuoka.
Neurol Med Chir (Tokyo). 1993 Dec;33(12):836-8. doi: 10.2176/nmc.33.836.
A 58-year-old female with pineocytoma developed intratumoral hemorrhage after ventriculoperitoneal shunting for hydrocephalus. Neurological examination revealed Parinaud's sign and papilledema. Computed tomography and magnetic resonance (MR) imaging revealed a pineal neoplasm and obstructive hydrocephalus. Serum and cerebrospinal fluid levels of human chorionic gonadotropin, alpha-fetoprotein, carcinoembryonic antigen, and placental alkaline phosphatase were negative or within normal limits. MR images after the ventriculoperitoneal shunting disclosed intratumoral hemorrhage and markedly smaller ventricles. The tumor was totally removed via the occipital transtentorial approach and was diagnosed histologically as a pineocytoma with astrocytic differentiation. The tumor probably shifted away from the surrounding structures following the marked reduction in ventricular size after ventriculoperitoneal shunting, resulting in changed venous circulation in the tumor and the formation of intratumoral hematoma.
一名58岁患有松果体细胞瘤的女性在因脑积水行脑室腹腔分流术后发生瘤内出血。神经系统检查发现有帕里诺德征和视乳头水肿。计算机断层扫描和磁共振成像显示松果体肿瘤及梗阻性脑积水。人绒毛膜促性腺激素、甲胎蛋白、癌胚抗原和胎盘碱性磷酸酶的血清及脑脊液水平均为阴性或在正常范围内。脑室腹腔分流术后的磁共振图像显示瘤内出血且脑室明显变小。肿瘤通过枕下经小脑幕入路被完全切除，组织学诊断为具有星形细胞分化的松果体细胞瘤。脑室腹腔分流术后脑室大小显著减小，肿瘤可能从周围结构移位，导致肿瘤内静脉循环改变并形成瘤内血肿。
