Thrombosed Middle Meningeal Artery Aneurysms Mimicking Aneurysmal Bone Cysts in a Patient with Fibrous Dysplasia
Thrombosed Middle Meningeal Artery Aneurysms Mimicking Aneurysmal Bone Cysts in a Patient with Fibrous Dysplasia
复制标题
DOI：
10.1016/j.wneu.2019.07.062
复制
发表时间：
2019-10-01
影响因子：
2
通讯作者：
Kohmura, Eiji
中科院分区：
文献类型：
--
作者：
Yamashita, Shunsuke;Kimura, Hidehito;Kohmura, Eiji
背景：动脉瘤性骨囊肿 (ABC) 是一种罕见的溶骨性病变，与骨疾病如纤维发育不良 (FD) 相关。病例描述：一名 66 岁女性，曾诊断患有 FD，出现视力突然下降。计算机断层扫描和磁共振成像显示中颅窝有一个大的溶骨性病变，已经侵入左眼眶。尽管其放射学结果与 ABC 一致，但旋转数字减影血管造影显示该溶骨性病变是一个大的脑膜中动脉 (MAA) 动脉瘤。为了释放对视神经的压迫力并明确诊断，我们进行了血管内栓塞，然后手术切除病变。组织学检查显示，切除的病灶符合血栓性动脉瘤的要求。术后未出现新的神经功能缺损，6个月随访期间未发现症状复发。结论：这是第一个病例报告表明FD患者的ABC样病变可能是血栓性MMA动脉瘤。因此，先前诊断为 ABC 的一些病变可能是血栓形成的 MMA 动脉瘤或包括血栓形成的 MMA 动脉瘤。因此，当我们在 FD 中遇到看似 ABC 的情况时，排除 MMA 动脉瘤的存在非常重要。
BACKGROUND: The aneurysmal bone cyst (ABC) is a rare osteolytic lesion that is associated with osseous disease such as fibrous dysplasia (FD).CASE DESCRIPTION: A 66-year-old woman previously diagnosed with FD presented with suddenly reduced visual acuity. Computed tomography and magnetic resonance imaging revealed a large osteolytic lesion in the middle cranial fossa that had invaded the left orbit. Although its radiological findings were compatible with an ABC, rotational digital subtraction angiography revealed that this osteolytic lesion was a large middle meningeal artery (MAA) aneurysm. To release the compression force on the optic nerve and confirm the diagnosis, we performed endovascular embolization, followed by surgical removal of the lesion. Histologic examination revealed that the resected lesion met the requirements of a thrombosed aneurysm. No new neurologic deficits appeared after the surgery, and no symptomatic recurrence have been noted during the 6-month follow-up.CONCLUSIONS: This is the first case report to show that ABC-like lesions patients with FD could be thrombosed MMA aneurysms. It is thus possible that some lesions previously diagnosed as ABCs were thrombosed MMA aneurysms or included a thrombosed MMA aneurysm. It is therefore important to rule out the presence of a MMA aneurysm when we encounter what appears to be an ABC in the presence of FD.