Hwang S L, Huang T Y, Chai C Y, Howng S L
Department of Pathology, Kaohsiung Medical College Hospital, Taiwan.
J Formos Med Assoc. 1998 Nov;97(11):784-7.
Hemorrhage of juvenile pilocytic astrocytomas is very rare. However, it is clinically important because a high probability of a fatal outcome exists if hemorrhage occurs outside the optic nerve. Hemorrhage of a hypothalamic juvenile pilocytic astrocytoma has been reported only once, from an autopsy examination. We present a successfully managed case. The patient, a 34-year-old man, presented with sudden loss of consciousness. Computed tomography (CT) and magnetic resonance imaging demonstrated an exophytic hypothalamic tumor with a hemorrhage. Craniotomy with total removal of the tumor and the hematoma was performed. Histopathologic examination revealed that the tumor was a juvenile pilocytic astrocytoma. Brain CT examination 18 months later revealed no evidence of tumor recurrence. The patient was well, without neurologic deficit, and had a normal social life as of the last follow-up examination 22 months after craniotomy.
青少年毛细胞型星形细胞瘤出血非常罕见。然而，其具有临床重要性，因为如果出血发生在视神经之外，则存在很高的致命结局可能性。下丘脑青少年毛细胞型星形细胞瘤出血仅有一次尸检报告。我们报告一例成功治疗的病例。患者为一名34岁男性，出现突发意识丧失。计算机断层扫描（CT）和磁共振成像显示一个带出血的下丘脑外生性肿瘤。进行了开颅手术并完全切除肿瘤和血肿。组织病理学检查显示肿瘤为青少年毛细胞型星形细胞瘤。术后18个月的脑部CT检查未发现肿瘤复发迹象。截至开颅术后22个月的最后一次随访检查，患者情况良好，无神经功能缺损，社会生活正常。
