Kuroiwa T, Moriwaki K, Ohta T, Tsutsumi A, Tajima S
Department of Neurosurgery, Osaka Medical College.
Neurol Med Chir (Tokyo). 1994 Jun;34(6):379-81. doi: 10.2176/nmc.34.379.
A 13-year-old boy presented with a primitive neuroectodermal tumor (PNET) with unusual extracranial extension. Precontrast computed tomography showed the tumor as a ring-shaped high-density area which was enhanced postcontrast, with a low-density center. Magnetic resonance imaging showed the tumor as a low-intensity area on the T1-weighted images with marked enhancement by gadolinium-diethylenetriaminepentaacetic acid, and high intensity on the T2-weighted images. The central area appeared as high intensity on both images, suggesting free methemoglobin. The tumor was subtotally removed. Histological examination demonstrated PNET. Despite irradiation (20 Gy) to the surgical site, and further tumor removal, he died 6 months later. This case showed PNET can extend extracranially. Diagnosis and treatment of such a tumor located extracranially and intracranially require careful consideration.
一名13岁男孩患有原始神经外胚层肿瘤(PNET),伴有不寻常的颅外扩展。平扫计算机断层扫描显示肿瘤为环形高密度区,增强扫描后强化,中心为低密度。磁共振成像显示肿瘤在T1加权图像上为低强度区,经钆喷酸葡胺显著强化,在T2加权图像上为高强度。中心区域在两种图像上均显示为高强度,提示存在游离高铁血红蛋白。肿瘤次全切除。组织学检查证实为PNET。尽管对手术部位进行了放疗(20 Gy)并进一步切除肿瘤,但他在6个月后死亡。该病例显示PNET可发生颅外扩展。对于这种位于颅外和颅内的肿瘤,其诊断和治疗需要仔细考虑。