Recurrence of a neurenteric cyst with malignant transformation in the foramen magnum after total resection - Case report
Recurrence of a neurenteric cyst with malignant transformation in the foramen magnum after total resection - Case report
复制标题
DOI：
10.3171/jns.2001.95.2.0341
复制
发表时间：
2001-08-01
影响因子：
4.1
通讯作者：
Yoshida, J
中科院分区：
文献类型：
--
作者：
Sahara, Y;Nagasaka, T;Yoshida, J
摘要一位53岁男性病患，在接受原发肿瘤全切除术后3.5年，因枕骨大孔处神经肠囊肿复发并恶变而就诊。初次手术后2年，患者状况良好，但随后因颅内高压接受脑室腹腔分流术。当时，磁共振（MR）图像上没有肿瘤复发的证据。一年半后，他出现头痛和食欲不振，在MR图像上发现了一个巨大的复发肿瘤。肿瘤与脑干、颅神经和血管严重粘连，仅允许部分切除。在第一次和第二次开颅手术中获得的肿瘤标本的组织学检查表明，从第一个标本中典型的单层上皮神经肠囊肿到第二个标本中乳头状增殖的腺癌的恶性变化。各种免疫组化结果。对第一个标本的研究是神经肠囊肿的典型研究。第二个标本显示比初始标本更强的碳水化合物19-9和癌胚抗原染色。Ki-67抗原（MIB-1）阳性细胞的百分比从第一份标本的0%增加到第二份标本的6.7%。据作者所知，这是第一例在枕骨大孔神经肠囊肿全切除后发生恶变的病例。
A 53-year-old man presented with recurrence of a neurenteric cyst with malignant transformation in the foramen magnum 3.5 years after total resection of the original tumor had been reported. For 2 years following the initial surgery, the patient had been in good condition, but then underwent ventriculoperitoneal shunt placement for intracranial hypertension. At the time there was no evidence of recurrence of the tumor on magnetic resonance (MR) images. One and one-half years later, he presented with headache and anorexia, A massive recurrent tumor was identified on MR images. The tumor was severely adhesive to the brainstem, cranial nerves, and vessels, allowing only partial resection. Histological examination of tumor specimens obtained during the first and second craniotoinies indicated a malignant change from a typical neurenteric cyst with a one-layer epithelium in the first specimen to an adenocarcinoma with papillary proliferation in the second. The results of various immunohistochemical. studies of the first specimen were typical of those of a neurenteric cyst. The second specimen displayed stronger staining of carbohydrate 19-9 and carcinoembryonic antigens than the initial specimen. The percentage of Ki-67 antigen (MIB-1)-positive cells increased from 0% in the first specimen to 6.7% in the second. To the authors' knowledge this is the first case in which malignant transformation has been demonstrated after total resection of a neurenteric cyst in the foramen magnum.