矢状旁脑膜血管瘤/孤立性纤维瘤:两个病例报告和文献综述

Asen H Cekov, D. Vezirska, Christo Tzekov Tzekov, Vladimir Stefanov Nakov
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摘要

孤立性纤维瘤/脑膜血管细胞瘤(SFT/M-HPC)是一种罕见肿瘤,约占颅内肿块的 1%。这种病变复发和转移到肝脏、肺部和骨骼等远处部位的风险很高。准确诊断需要详细的组织病理学检查。我们报告了两例 SFT/M-HPC 病例。第一个病例是一名 44 岁女性,数月来出现头痛、恶心、呕吐和额部共济失调。影像学检查结果显示她有一个巨大的矢状旁轴外肿块,压迫两个侧脑室的额角。她接受了大体全切除术,术后并无并发症。在 5 年的随访期间,患者没有出现肿瘤复发或远端转移。第二个病例是一名 48 岁的男性,出现右侧偏盲和偏瘫。计算机断层扫描(CT)显示,他的顶枕部有一个巨大的轴外肿块,上矢状窦被吞噬,大脑半球间裂隙脱位。他接受了大体全切除术,术后并无大碍。六年后,他出现右侧肢体无力。CT 扫描显示,在之前的位置有一个多灶复发性肿块。术前影像学检查发现脑膜瘤样肿块时,应考虑 SFT/M-HPC。免疫组化检查是正确诊断的关键。严格的长期随访检查和定期磁共振成像扫描是防止出现转移和巨大复发肿块的关键。
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Parasagittal meningeal hemangiopericytoma/solitary fibrous tumor: Two case reports and a literature review
Solitary fibrous tumor/meningeal hemangiopericytoma (SFT/M-HPC) is a rare neoplasm which accounts for around 1% of the intracranial masses. This pathology has a high risk for recurrence and metastasis to distant locations such as the liver, lungs, and bones. Precise diagnosis necessitates detailed histopathological examination. We present two case reports of SFT/M-HPC. The first case is a 44-year-old female who presented with headache, nausea, vomiting, and frontal ataxia for several months. Imaging findings showed a large parasagittal extra-axial mass with compression of the frontal horns of both lateral ventricles. She underwent gross total resection with an uncomplicated postoperative period. The patient had no recurrent tumors or distal metastases in the follow-up period of 5 years. The second case is a 48-year-old male who presented with right-sided hemianopsia and hemiparesis. Computed tomography (CT) scans revealed a large parieto-occipital extra-axial mass with superior sagittal sinus engulfment and dislocation of the interhemispheric fissure. He underwent gross total resection with an uncomplicated postoperative period. Six years later, he presented with right-sided weakness. CT scan showed a multifocal recurrent mass at the previous location. He underwent subtotal resection with an uncomplicated postoperative period. SFT/M-HPC should be considered when presented with a meningioma-like tumor mass on preoperative imaging. Immunohistochemical study is crucial for the correct diagnosis. Strict long-term follow-up examinations and regular magnetic resonance imaging scans are key to preventing the appearance of metastases and large recurrent masses.
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