Fuse T, Takagi T, Hirose M
Department of Neurosurgery, Nagoya City Higashi General Hospital.
Neurol Med Chir (Tokyo). 1995 Jun;35(6):364-8. doi: 10.2176/nmc.35.364.
A 39-year-old male presented with an exceedingly rare primary intracranial epithelioid angiosarcoma in the right parietal lobe manifesting as weakness of the left hand. Neuroimaging revealed a well-defined intensely enhanced lesion in the right parietal lobe with peripheral cerebral edema. The tumor was grossly totally removed. Light microscopy of the surgical specimens revealed features typical of an epithelioid vascular tumor. The tumor cells showed intense positive immunohistochemical staining for cytokeratin and vimentin and focally positive staining for both Ulex europaeus agglutinin and anti-human endothelial cells, CD31. Tumor regrowth required two further operations. This progressive growth was consistent with an angiosarcoma. The tumor was diagnosed as an epithelioid angiosarcoma based on the histological and clinical characteristics. He became progressively obtunded and finally died. This is the first intracranial epithelioid angiosarcoma which expressed epithelial markers detectable by immunohistochemical methods.
一名39岁男性,因右顶叶极为罕见的原发性颅内上皮样血管肉瘤就诊,表现为左手无力。神经影像学检查显示右顶叶有一个边界清晰、强化明显的病灶,周围伴有脑水肿。肿瘤在肉眼下被完全切除。手术标本的光镜检查显示出上皮样血管肿瘤的典型特征。肿瘤细胞对细胞角蛋白和波形蛋白呈强阳性免疫组化染色,对欧洲荆豆凝集素和抗人内皮细胞CD31呈局灶性阳性染色。肿瘤复发需要再次进行两次手术。这种进行性生长符合血管肉瘤的表现。根据组织学和临床特征,该肿瘤被诊断为上皮样血管肉瘤。患者逐渐变得昏迷,最终死亡。这是首例通过免疫组化方法可检测到表达上皮标志物的颅内上皮样血管肉瘤。