轴外型桥小脑角区髓母细胞瘤2例报告及文献复习
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摘要
目的:探讨轴外型桥小脑角(CPA)区髓母细胞瘤(MB)的临床特点,分析其影像学特征和临床预后,为其临床诊断和治疗提供参考。方法:收集2例诊断为轴外型CPA区MB患者的临床资料;结合相关文献,分析该病的临床特点、诊断和治疗方法。结果:2例患者因头痛伴听力下降入院,头部核磁共振(MRI)平扫及增强提示CPA占位性病变。2例患者均行CPA区肿瘤切除术。2例患者手术顺利,术中可见肿瘤位于轴外,术后病理证实为MB,随访15个月未见肿瘤复发和转移。结论:对于轴外型CPA占位性病变,术前应考虑MB的可能性。积极的手术治疗有助于改善预后并延长患者的生存期。
Objective:To investigate the clinical features of extra-axial medulloblastoma(MB)in the cerebellopontine angle(CPA)area and analyze the imaging features and clinical prognosis,and to provide the reference for its clinical diagnosis and treatment.Methods:The clinical data of two patients diagnosed as extra-axial MB in CPA area were collected;the literature review was performed,and the clinical characteristics,diagnostic and treatment methods were analyzed.Results:Two patients were admitted to the hospital due to headache accompanied by hearing loss.The magnetic resonance imaging(MRI)results indicated a mass in the CPA area.All the two patients were treated with the cerebellopontine angle tumor resection.The operation of the two patients was successful,and the tumor located outside the axis seen in the operation,which was confirmed as MB by postoperative pathology. No recurrence or metastasis of tumor was found 15 months after follow-up.Conclusion:The possibility of MB should be considered before operation for the occupying lesions in the extra-axial CPA area.The active operation can improve the prognosis and prolong the survival of the patients.
Objective:To investigate the clinical features of extra-axial medulloblastoma(MB)in the cerebellopontine angle(CPA)area and analyze the imaging features and clinical prognosis,and to provide the reference for its clinical diagnosis and treatment.Methods:The clinical data of two patients diagnosed as extra-axial MB in CPA area were collected;the literature review was performed,and the clinical characteristics,diagnostic and treatment methods were analyzed.Results:Two patients were admitted to the hospital due to headache accompanied by hearing loss.The magnetic resonance imaging(MRI)results indicated a mass in the CPA area.All the two patients were treated with the cerebellopontine angle tumor resection.The operation of the two patients was successful,and the tumor located outside the axis seen in the operation,which was confirmed as MB by postoperative pathology. No recurrence or metastasis of tumor was found 15 months after follow-up.Conclusion:The possibility of MB should be considered before operation for the occupying lesions in the extra-axial CPA area.The active operation can improve the prognosis and prolong the survival of the patients.
引文
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[15]BAYRAM I,IBILOGLU I,UGRAS S,et al.Desmoplastic medulloblastoma in a 48-year-old male[J].Tohoku J Exp Med,2004,204(4):317-322.
[16]MENON G,KRISHNAKUMAR K,NAIR S.Adult medulloblastoma:clinical profile and treatment results of18patients[J].J Clin Neurosci,2008,15(2):122-126.
[17]CHAN A W,TARBELL N J,BKACK P M,et al.Adult medulloblastoma:prognostic factors and patterns of relapse[J].Neurosurgery,2000,47(3):623-631.
[2]QUINLAN A,RIZZOLO D.Understanding medulloblastoma[J].JAAPA,2017,30(10):30-36.
[3]PHOENIX T N,PATMORE D M,BOOP S,et al.Medulloblastoma genotype dictates blood brain barrier phenotype[J].Cancer Cell,2016,29(4):508-522.
[4]RAYWAT N,VICH Y,CHATCHAI T.Cerebellopontine angle medulloblastoma with extensivenodularity in a child:case report and review of the literature[J].Childs Nerv Syst,2017,33(5):839-842.
[5]MUKESH K B,MANISH J,BAL K O,et al.Extra-Axial cerebellopontine angle medulloblastoma in an infant[J].Pediatr Neurosurg,2017,52(2):122-126.
[6]BAHRAMI E,BAKHTI S,FERESHTEHNEJAD S M,et al.Extra-axial medulloblastoma in cerebellopontine angle:A report of a rare case with literature review[J].Med JIslam Repub Iran,2014,28:57.
[7]NEUMANN J E,SWARTLING F J,SCHULLER U,et al.Medulloblastoma:experimental models and reality[J].Acta Neuropathol,2017,134(5):679-689.
[8]GUPTA T,SHIRSAT N,JALALI R.Molecular subgrouping of medulloblastoma:Impact upon research and clinical practice[J].Curr Pediatr Rev,2015,11(2):106-119.
[9]CZERNICHI T,KUNERT P,NOWAK A,et al.Epidermoid cysts of the cerebellopontine angle:Clinical features and treatment outcomes[J].Neurol Neurochir Pol,2016,50(2):75-82.
[10]KALOGERAKI A,TAMIOLAKIS D,ZOI L,et al.Schwannoma of right cerebellopontine angle.A cytologic diagnosis[J].Acta Biomed,2018,89(3):411-441.
[11]SPINA A,BOARI N,GAGLIARDI F,et al.Review of cerebellopontine angle medulloblastoma[J].Br J Neurosurg,2013,27(3):316-320.
[12]FURTADO S V,VENKATESH P K,DADLANI R,et al.Adult medulloblastoma and the“dural-tail”sign:rare mimic of aposterior petrous meningioma[J].Clin Neurol Neurosurg,2009,111(6):540-543.
[13]BOCKMAYR M,MOHME M,KLAUSCHEN F,et al.Subgroup-specific immune and stromal microenvironment in medulloblastoma[J].Oncoimmunology,2018,7(7):e1462430.
[14]JOHNSTON D L,KEENE D,STROTHER D,et al.Survival following tumor recurrence in children with medulloblastoma[J].J Pediatr Hematol Oncol,2018,40(3):e159-e163.
[15]BAYRAM I,IBILOGLU I,UGRAS S,et al.Desmoplastic medulloblastoma in a 48-year-old male[J].Tohoku J Exp Med,2004,204(4):317-322.
[16]MENON G,KRISHNAKUMAR K,NAIR S.Adult medulloblastoma:clinical profile and treatment results of18patients[J].J Clin Neurosci,2008,15(2):122-126.
[17]CHAN A W,TARBELL N J,BKACK P M,et al.Adult medulloblastoma:prognostic factors and patterns of relapse[J].Neurosurgery,2000,47(3):623-631.