Comey C H, McLaughlin M R, Jho H D, Martinez A J, Lunsford L D
Department of Neurological Surgery, University of Pittsburgh Medical Center, Pennsylvania, USA.
J Neurosurg. 1998 Oct;89(4):653-8. doi: 10.3171/jns.1998.89.4.0653.
Malignant vestibular nerve tumors are rare: to date, only three cases have been reported in the literature. The authors report a case of an eighth cranial nerve tumor that progressed 5 years after stereotactic radiosurgery. The patient was a 44-year-old man who underwent stereotactic radiosurgery for a 27-mm cerebellopontine angle tumor that was discovered on investigation of tinnitus and hearing loss. He developed facial weakness after 5 years, and repeated imaging revealed tumor enlargement. Despite complete microsurgical excision, the tumor rapidly recurred locally and subsequently disseminated within the neuraxis. The patient died 1 year after tumor progression was detected. Histopathological analysis revealed a malignant spindle cell neoplasm with frequent mitotic figures. The presence of positive rhabdoid elements on immunohistochemical studies confirmed that it was a triton tumor. The authors review the relevant literature concerning the classification and management of malignant vestibular nerve tumors and discuss the implications of tumor progression after stereotactic radiosurgery.
迄今为止，文献中仅报道过3例。作者报告了1例在立体定向放射外科治疗5年后进展的第八颅神经肿瘤病例。患者为一名44岁男性，因耳鸣和听力损失检查发现27mm的小脑脑桥角肿瘤而接受立体定向放射外科治疗。5年后他出现面部无力，重复成像显示肿瘤增大。尽管进行了完整的显微手术切除，但肿瘤迅速在局部复发，随后在神经轴内播散。在检测到肿瘤进展1年后患者死亡。组织病理学分析显示为具有频繁有丝分裂象的恶性梭形细胞瘤。免疫组织化学研究中横纹肌样阳性成分的存在证实其为蝾螈瘤。作者回顾了有关恶性前庭神经肿瘤分类和治疗的相关文献，并讨论了立体定向放射外科治疗后肿瘤进展的影响。
