Clinical and Radiological Characteristics of Malignant Tumors Located to the Cerebellopontine Angle and/or Internal Acoustic Meatus
Clinical and Radiological Characteristics of Malignant Tumors Located to the Cerebellopontine Angle and/or Internal Acoustic Meatus
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桥小脑角和/或内耳道恶性肿瘤的临床和放射学特征
DOI：
10.1097/mao.0000000000002360
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Kania R.
中科院分区：
文献类型：
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作者：
Eliezer M;Tran H;Inagaki A;Vérillaud B;Takahashi M;Marie JP;Hautefort C;Herman P;Murakami S;Kania R.
目的：内耳道和/或桥小脑角转移性病变很少见，可能表现为前庭神经鞘瘤。本文提出了法国和日本三个转诊中心对9例CPA和IAM恶性病例的诊断和治疗问题。本研究的目的是：1）报告CPA的恶性病变，其诊断和治疗，2）回顾文献，3）提出怀疑为恶性肿瘤的CPA.Methods：9例恶性病变的CPA和/或IAM的最终诊断是由手术，腰椎穿刺，或PET扫描。测量的主要结果是：快速发作的症状，与面神经麻痹的耳蜗前庭症状，和MRI analysis.Results：9例恶性肿瘤的CPA，其中8例（89%）有面神经麻痹与耳蜗前庭症状。77%（7/9）的病例肿瘤生长迅速，平均生长时间为4.6个月。44%（4/9）的患者首次诊断为VS。MRI表现不典型者占67%（6/9），双侧肿瘤占55%（5/9）。结论：CPA和（或）IAM恶性肿瘤虽然少见，但如果伴有耳蜗前庭症状和面瘫，起病快，MRI表现不典型，应引起警惕。
Objective:Metastatic lesions to the internal auditory meatus (IAM) and/or the cerebellopontine angle (CPA) are rare and may appear like a vestibular schwannoma (VS). We herein raise the issue of the diagnosis and treatment of nine malignant cases of the CPA and IAM among three referral centers in France and Japan. The aim of this study was 1) to report malignant lesions of the CPA, their diagnosis and treatment, 2) to review the literature, 3) to propose criteria of suspicion for malignant tumors of the CPA.Methods:Nine patients who had malignant lesions of the CPA and/or IAM for whom the final diagnosis was made by surgery, lumbar puncture, or PET scan were included. The main outcomes measured were: rapid onset of symptoms, association of cochlea-vestibular symptoms with facial palsy, and MRI analysis.Results:Among the nine patients with malignant tumor of the CPA, 8 of them (89%) had a facial palsy associated with cochlea-vestibular symptoms. Rapid growth of the tumor was observed in 77%(7/9) of the cases in a mean time interval of 4.6 months. The initial diagnosis evoked was VS in 44% of the cases (4/9). Atypical MRI aspect was seen in 67% of the cases (6/9) with bilateral tumors in 55% of cases (5/9).Conclusion:Although rare, malignant tumors of the CPA and/or IAM should be evoked in case of association of cochleovestibular symptoms and facial palsy, rapid onset and atypical MRI aspect.