脑室内垂体细胞瘤:说明性病例。
Intraventricular pituicytoma: illustrative case.
发表日期:2024 Aug 26
作者:
Takashi Hanyu, Ryota Ishibashi, Kazushi Kitamura, Namiko Nishida, Yoshiaki Yuba, Gen Honjo, Kaishi Satomi, Koichi Ichimura, Junji Shibahara, Takeshi Sawada, Takayoshi Ishimori, Noriyoshi Takebe, Hirokuni Hashikata, Hiroki Toda
来源:
Cellular & Molecular Immunology
摘要:
垂体细胞瘤是一种罕见的神经胶质肿瘤,来自神经垂体或漏斗部的垂体细胞。它发生在鞍区和鞍上区,在不影响漏斗部或漏斗部隐窝的情况下观察到脑室内垂体细胞瘤的情况极为罕见。 一名 69 岁男性患有进行性痴呆 6 个月。磁共振成像显示第三脑室前部有一个固体、均匀增强的肿块,并有流动空隙。蝶鞍、鞍上区、漏斗部和漏斗部隐窝不受影响。该患者接受了经胼胝体经脉络膜入路,由于肿瘤出血严重,最终部分切除了肿瘤。第二次手术导致其部分切除。肿瘤具有双极细胞,其细胞核对甲状腺转录因子 1 具有免疫反应性。 DNA甲基化分析对应于垂体细胞瘤、颗粒细胞瘤和梭形细胞嗜酸细胞瘤的甲基化类别。垂体细胞瘤是基于这些结果的诊断。一项系统回顾发现了 5 例脑室内垂体细胞瘤病例。脑室内垂体细胞瘤可以在不累及漏斗部或漏斗部隐窝的情况下生长。目前的病例表明,下丘脑灰结节的垂体细胞也可引起垂体细胞瘤。由于脑室内垂体细胞瘤的血管丰富性,必须控制术中出血并注意邻近的下丘脑。 https://thejns.org/doi/10.3171/CASE24247。
Pituicytoma is a rare glial neoplasm from pituicytes of the neurohypophysis or infundibulum. It occurs in the sella and suprasellar area, and it is extremely uncommon to observe intraventricular pituicytoma without affecting the infundibulum or infundibular recess.A 69-year-old man had suffered progressive dementia for 6 months. Magnetic resonance imaging revealed a solid, homogeneously enhancing mass with flow voids within the anterior third ventricle. The sella, suprasellar area, infundibulum, and infundibular recess were unaffected. The patient underwent a transcallosal transchoroidal approach, which ended in partial removal of the tumor due to significant tumoral bleeding. A second surgery resulted in its subtotal removal. The tumor had bipolar cells, and their nuclei were immunoreactive for thyroid transcription factor-1. A DNA methylation analysis corresponded to the methylation class of pituicytoma, granular cell tumor, and spindle cell oncocytoma. Pituicytoma was the diagnosis based on these results. A systematic review identified 5 intraventricular pituicytoma cases.Intraventricular pituicytoma can grow without involvement of the infundibulum or infundibular recess. The current case suggests that pituicytes of the hypothalamic tuber cinereum can also give rise to pituicytoma. Because of the hypervascular nature of intraventricular pituicytomas, it is imperative to control intraoperative bleeding with attention to the adjacent hypothalamus. https://thejns.org/doi/10.3171/CASE24247.