鞍区神经鞘膜瘤1例并文献复习

摘要

目的 探讨鞍区神经鞘膜瘤的发生机制、临床表现、影像学表现、组织病理学特征、诊断、鉴别诊断以及治疗方法.方法 对1例鞍区神经鞘膜瘤患者的临床资料进行分析,并结合文献进行讨论.结果 患者表现为头痛、视物模糊,头颅MR可见鞍区椭圆形占位,T1 W1呈等信号,T2W1呈高信号,FLAIR呈高信号,增强后均一强化.经开颅手术切除肿瘤,病理组织学检查可见梭形肿瘤细胞,免疫组化S-100、PGP9.5均(+),EMA、GFAP、CK34、D2-40、PR均(-),确诊为神经鞘膜瘤.患者术后痊愈出院.结论 鞍区神经鞘膜瘤极为罕见,肿瘤的发生机制目前仍有争议,最终诊断依赖于病理组织学检查.%Objective To investigate the pathogenesis,clinical,imaging and pathological features,diagnosis,differential diagnosis and treatment of Schwannomas located on sellar region.Methods To describe and analyze one rare case and discuss the case combined with the published reports.Results Patient complaint of headache and visional blur,MR revealed occupied lesion with iso-signal in T1WI,high signal in T2WI,and high signal in FLAIR,and hyperenhancement.The tumor of this case was resected by craniotomy.The pathological examination revealed Schwannomas confirmed by the immunohistochemical staining,S-100 and PGP 9.5 are positive,EMA,GFAP,CK34,D2-40,PR are negtive.The patient was discharged without neurological deficit.Conclusion The Schwannomas located on sellar region are extremely rare,the pathogenesis of the tumor still remains dispute,and the final diagnosis depends on the pathological examination.