Wakamoto H, Miyazaki H, Hayashi T, Shimamoto Y, Ishiyama N
Department of Neurosurgery, Hiratsuka City Hospital.
No Shinkei Geka. 1998 Mar;26(3):247-52.
Cystic meningiomas are not commonly encountered and are said to account for only 1 to 2% of all types of meningioma. There have been several reports on them and most of them were discussed under the aspect of the mechanism of cystic formation. Though few reports present the process of cystic formation, here we were able to present the process of cystic formation with intratumoral hemorrhage. The case was a 56-year-old man who presented with urinary incontinence. MRI revealed a large cystic tumor in the right frontal lobe and he was admitted to another hospital. After 20 days, MRI incidentally revealed hematoma near the intratumoral cyst. Two weeks later, MRI revealed that the hematoma flowed out the cyst and the cavity of the hematoma communicated with the cyst. Angiography showed that the tumor was fed by the left anterior ethmoid artery. After surgical removal of the tumor, histopathological diagnosis was that the tumor was a transitional meningioma and there were no findings of malignancy. Commonly, intratumoral hemorrhage is unusual for a meningioma but we suspect that there are not a few cases in which small hemorrhage occurred without symptoms and the hematoma cavity joined the intratumoral cyst while the cyst grew gradually.
囊性脑膜瘤并不常见，据说仅占所有类型脑膜瘤的1%至2%。关于它们已有多篇报道，其中大部分是从囊性形成机制的角度进行讨论的。虽然很少有报道介绍囊性形成的过程，但我们在此能够呈现伴有肿瘤内出血的囊性形成过程。该病例为一名56岁男性，表现为尿失禁。磁共振成像（MRI）显示右额叶有一个巨大的囊性肿瘤，他被收治于另一家医院。20天后，MRI偶然发现肿瘤内囊肿附近有血肿。两周后，MRI显示血肿流入囊肿，且血肿腔与囊肿相通。血管造影显示肿瘤由左前筛动脉供血。手术切除肿瘤后，组织病理学诊断为过渡型脑膜瘤，未发现恶性特征。通常，肿瘤内出血在脑膜瘤中并不常见，但我们怀疑有不少病例存在小出血未出现症状，且在囊肿逐渐增大时血肿腔与肿瘤内囊肿相连的情况。
