以视力下降为主要症状的老年鞍上区非典型脉络丛乳头状瘤1例报告及文献复习

doi:10.13481/j.1671-587x.20200527

吉林大学学报(医学版) ›› 2020, Vol. 46 ›› Issue (05): 1065-1069.doi: 10.13481/j.1671-587x.20200527

• 临床医学 • 上一篇

以视力下降为主要症状的老年鞍上区非典型脉络丛乳头状瘤1例报告及文献复习

马小山¹, 孙婧², 曲丽梅³, 曹赢坤⁴, 刘文彬¹, 赵钥¹, 李蕴潜¹

1. 吉林大学第一医院神经外科, 吉林长春 130021;
2. 吉林大学第一医院麻醉科, 吉林长春 130021;
3. 吉林大学第一医院病理科, 吉林长春 130021;
4. 吉林大学第一医院超声科, 吉林长春 130031

收稿日期:2020-03-13 发布日期:2020-10-23
通讯作者: 李蕴潜,主任医师,博士研究生导师(Tel:0431-81875701,E-mail:yunqianli_jdyy@163.com) E-mail:yunqianli_jdyy@163.com
作者简介:马小山(1991-),男,吉林省松原市人,在读医学硕士,主要从事中枢神经系统肿瘤基础和临床方面的研究。
基金资助:
国家自然科学基金资助课题（81672505）

Atypical choroid plexus papilloma in suprasellar region of elderly with impaired vision as main symptom:A case report and literature review

MA Xiaoshan¹, SUN Jing², QU Limei³, CAO Yingkun⁴, LIU Wenbin¹, ZHAO Yao¹, LI Yunqian¹

1. Department of Neurosurgery, First Hospital, Jilin University, Changchun 130021, China;
2. Department of Anesthesiology, First Hospital, Jilin University, Changchun 130021, China;
3. Department of Pathology, First Hospital, Jilin University, Changchun 130021, China;
4. Department of Ultrasonography, First Hospital, Jilin University, Changchun 130031, China

Received:2020-03-13 Published:2020-10-23

摘要/Abstract

摘要： 目的：分析以视力下降为主要症状的老年男性鞍上区非典型脉络丛乳头状瘤（ACPP）患者的临床表现、影像学特征和治疗方法，为该病的诊疗提供参考。方法：收集1例以视力下降为主要症状的鞍上区ACPP患者的临床资料，分析该病的临床特点、诊断及治疗方法，并进行相关文献复习。结果：患者，男性，61岁，因"持续性头痛1年余、双眼视力进行性下降2个月余"入院。实验室检查，0：00和8：00时血清皮质醇含量降低；头部MRI检查显示鞍上区椭圆形肿块，大小为3.2 cm×2.7 cm×2.0 cm，T1WI显示不均匀低信号，T2WI显示不均匀高信号，增强扫描可见团块状高低混杂信号影，周边可见花环状强化，实验室检查及头部MRI检查提示不排除胶质瘤诊断，限期选择额下入路行鞍上区占位切除术切除全部肿物，病理诊断为ACPP。该患者术后未接受放化疗，术后随访未见复发。结论：ACPP是一种低度恶性肿瘤，无特异性影像学表现，手术全切是有效的治疗方式，病理学诊断是本病诊断的金标准，ACPP患者术后应定期随访。

关键词: 非典型脉络丛乳头状瘤, 鞍上区脉络丛乳头状瘤, 脉络丛肿瘤, 鞍上区

Abstract: Objective: To analyze the clinical features, imaging characteristics and treatment of the male elderly patient with atypical choroid plexus papilloma(ACPP) in the suprasellar region existing impaired vision as main symptom, and to provide the basis for the diagnosis and treatment of the disease. Methods: The clinical data of a patient with ACPP in the suprasellar region existing impaired vision as main symptom were collected, and the clinical features, diagnosis and treatment of ACPP were analyzed, and the relative literatures were reviewed. Results: A 61-year-old male patient was admitted to the hospital with a more than 1 year history of headache and a more than 2 months history of progressive decline in binocular vision. The laboratory examination results revealed that the serum cortisol contents at 00:00 and 8:00 were decreased. The results of brain magnetic resonance imaging (MRI) examination showed a 3.2 cm×2.7 cm×2.0 cm oval mass in the suprasellar region with inheterogeneous hypointensity on T1WI and inheterogeneous hyperintensity on T2WI.The enhanced scranning results showed that the lesion exhibited mixed hypointensity and hyperintensity with blocky in shape and flower ring-like ehancement in its surrounding. The results of laboratory examination and MRI indicated that diagnosis of glioma was not excluded. The patient underwent semi-elective operation and the tumor was resected completely; the pathological diagnosis was ACPP. The patient did not receive radiotherapy or chemotherapy after operation. There was no recurrence after follow-up. Conclusion: ACPP is a kind of low grade malignant tumor without specific imaging findings. Total resection is an effective treatment. Pathological diagnosis is the gold standard for the diagnosis of ACPP. The patients with ACPP diagnosed by pathology should regularly receive reexamination after operation.

Key words: atypical choroid plexus papilloma, choroid plexus papilloma in suprasellar region, choroid plexus neoplasms, suprasellar region

中图分类号:

R651.1

马小山, 孙婧, 曲丽梅, 曹赢坤, 刘文彬, 赵钥, 李蕴潜. 以视力下降为主要症状的老年鞍上区非典型脉络丛乳头状瘤1例报告及文献复习[J]. 吉林大学学报(医学版), 2020, 46(05): 1065-1069.

MA Xiaoshan, SUN Jing, QU Limei, CAO Yingkun, LIU Wenbin, ZHAO Yao, LI Yunqian. Atypical choroid plexus papilloma in suprasellar region of elderly with impaired vision as main symptom:A case report and literature review[J]. Journal of Jilin University(Medicine Edition), 2020, 46(05): 1065-1069.

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以视力下降为主要症状的老年鞍上区非典型脉络丛乳头状瘤1例报告及文献复习

Atypical choroid plexus papilloma in suprasellar region of elderly with impaired vision as main symptom:A case report and literature review

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