Vernet O, Farmer J P, Meagher-Villemure K, Montes J L
Department of Neurosurgery, Montreal Children's Hospital, McGill University, Quebec, Canada.
Can J Neurol Sci. 1995 Nov;22(4):316-9. doi: 10.1017/s0317167100039561.
Ependymomas usually arise from the ventricular surface.
We report an 11-year-old female who presented with a supratentorial ectopic ependymoma.
The patient presented with a two-month-history of progressive headache, nausea and vomiting. Examination revealed papilledema, horizontal nystagmus, diplopia on upward gaze, and right pronator drift. CT scan showed an enhancing left precentral subcortical lesion measuring 3 cm in diameter with associated edema and mass effect. Its medial border was located 3 cm from the ependymal surface of the ventricle. A firm tumour was dissected from the centrum semiovale white matter, and removed in toto as confirmed on MRI. Pathological examination revealed histological, immuno-histochemical and electron microscopic features consistent with an ependymoma. Spine MRI and bone marrow aspirate, as well as lumbar puncture of cytology failed to show any dissemination.
From the literature review, this represents an exceptional ependymoma located at the distance from the ventricular system or cisterns. Different pathogenic alternatives are discussed.
室管膜瘤通常起源于脑室表面。
我们报告了一名11岁女性,她患有幕上异位室管膜瘤。
该患者有两个月的进行性头痛、恶心和呕吐病史。检查发现视乳头水肿、水平眼球震颤、向上凝视时复视以及右侧旋前肌漂移。CT扫描显示左中央前回皮质下有一个直径3 cm的强化病变,伴有相关水肿和占位效应。其内侧边界距脑室室管膜表面3 cm。从半卵圆中心白质中分离出一个质地坚实的肿瘤,并如MRI所证实的那样将其完整切除。病理检查显示组织学、免疫组织化学和电子显微镜特征与室管膜瘤一致。脊柱MRI、骨髓穿刺以及腰椎穿刺细胞学检查均未发现任何播散。
通过文献回顾,这是一例位于距脑室系统或脑池有一定距离处的罕见室管膜瘤。文中讨论了不同的致病可能性。