Shimizu J, Kaito N, Akiba Y, Okuda Y, Tashibu K, Abe T, Ushigome S
Department of Neurosurgery, Jikei University School of Medicine.
No Shinkei Geka. 1997 Jun;25(6):555-9.
A 30-year-old male had been suffering from left temporalgia of six months duration and then developed left hearing disturbance. Craniogram and bone window CT revealed a well defined osteolytic lesion in the left temporal bone. CT scan showed an expansile heterogenous mass with calcification. Both T1 and T2 weighted MRI demonstrated a well lobulated mixed intensity mass, but no evidence of dural or intracranial invasion. The tumor exhibited homogenous enhancement on CT and MRI. Angiogram revealed a well marked staining supplied by the left middle meningeal and deep temporal arteries. Subtotal removal of the tumor was carried out with cranioplasty. Histologically, this tumor was composed of round or polygonal chondroblasts, scattered osteoclast-like giant cells with a foci of cartilage in the stroma. Many reports describe giant cell tumor can be differentiated by immunohistochemical demonstration of S100 protein. Although in our case, histological findings simulated those of eosinophilic granuloma, it was diagnosed as chondroblastoma because of the foci of cartilage in the stroma. Because this tumor is usually benign, recurrence of the tumor is rare after surgical resection. Post-operative irradiation has been reported to be effective in decreasing the recurrence of the tumor. But it should be carefully observed because of possible sarcomatous change in such tumors.
一名30岁男性，左侧颞部疼痛6个月，随后出现左耳听力障碍。头颅平片和骨窗CT显示左侧颞骨有一个边界清晰的溶骨性病变。CT扫描显示一个有钙化的膨胀性不均匀肿块。T1加权和T2加权MRI均显示一个边界清晰的分叶状混合密度肿块，但无硬脑膜或颅内侵犯的证据。肿瘤在CT和MRI上均表现为均匀强化。血管造影显示由左侧脑膜中动脉和颞深动脉供血的明显染色。行肿瘤次全切除并颅骨成形术。组织学上，该肿瘤由圆形或多边形软骨母细胞、散在的破骨细胞样巨细胞组成，基质中有软骨灶。许多报道描述巨细胞瘤可通过免疫组化显示S100蛋白来鉴别。虽然在我们的病例中，组织学表现类似嗜酸性肉芽肿，但由于基质中有软骨灶，故诊断为软骨母细胞瘤。因为这种肿瘤通常是良性的，手术切除后肿瘤复发罕见。据报道，术后放疗对降低肿瘤复发有效。但由于此类肿瘤可能发生肉瘤样变，应仔细观察。
