Akimoto J, Takeda H, Hashimoto T, Haraoka J, Ito H
Department of Neurosurgery, Tokyo Medical College.
No Shinkei Geka. 1996 Nov;24(11):1021-5.
The authors report a rare case of ecchordosis physaliphora (EP) in the prepontine region. A 51-year-old woman was admitted with a small cystic mass in the prepontine region, complaining of headache and an episode of transient double vision. Plain X-ray and lateral tomography films showed a protrusive hyperostosis at the middle clival region. The CT scan showed no abnormal densities in the retroclival region, and CT cisternography showed an isolated small round mass in the prepontine cistern. A small cystic mass with no enhancement with Gd-DTPA was revealed on MRI, mildly compressing the basilar artery and the rostral surface of the pons. The totally excised mass was pedunculated and was contiguous with the dorsal wall of the clivus via a small dural defect. The histologic diagnosis was EP, consisting of scattered physaliphorous cell nests, which were not positive for MIB-1 staining. The pedicle consisted of mature cartilaginous cells. The authors briefly reviewed the few previously reported cases of symptomatic EP and intradural chordoma, and discussed the differences between them. The histological features, especially the proliferation potential, may be pathognomonic. The histogenesis and the clinical features of symptomatic EP are also provided.
作者报告了一例罕见的脑桥前区泡状脊索瘤（EP）病例。一名51岁女性因脑桥前区出现一个小的囊性肿块入院，主诉头痛和一次短暂性复视发作。普通X线和侧位体层摄影片显示斜坡中部区域有突出的骨质增生。CT扫描显示斜坡后区域无异常密度，CT脑池造影显示脑桥前池有一个孤立的小圆形肿块。MRI显示一个小的囊性肿块，注射钆喷酸葡胺后无强化，轻度压迫基底动脉和脑桥的嘴侧表面。完全切除的肿块有蒂，通过一个小的硬脑膜缺损与斜坡后壁相连。组织学诊断为EP，由散在的泡状细胞巢组成，MIB-1染色呈阴性。蒂由成熟软骨细胞组成。作者简要回顾了少数先前报道的有症状的EP和硬膜内脊索瘤病例，并讨论了它们之间的差异。组织学特征，尤其是增殖潜能，可能具有诊断意义。还介绍了有症状的EP的组织发生和临床特征。
