Neurology病例:Ollier病中经组织病理学证实的颅内内生软骨瘤/低级别软骨肉瘤和IDH1突变的弥漫性胶质瘤

2022-08-11 神经科病例撷英拾粹 神经科病例撷英拾粹

Ollier病中经组织病理学证实的颅内内生软骨瘤/低级别软骨肉瘤和IDH1突变的弥漫性胶质瘤病例分享。

3岁女孩,表现为腿部畸形,诊断为内生软骨瘤病(enchondromatosis)(Ollier病),这是一种罕见散发的骨骼疾病,其特征是长骨干骺端软骨细胞错构生长。2008年,发现其左侧额叶(图A)液体衰减反转恢复序列(FLAIR)高信号和颅底内生软骨瘤(图B)。患者的内生软骨瘤病需要切除沉重且无法使用的手指(图C-D)。2017 年,复查影像显示额叶肿瘤扩大,行开颅手术,病理提示WHO 2级星形胶质细胞瘤。Ollier病与IDH突变有关,必须监测患者是否有内生软骨瘤的肉瘤转化和骨外恶性肿瘤(包括胶质瘤)。

(图:FLAIR可见IDH1突变的2级弥漫性星形胶质细胞瘤[A]合并蝶骨内生软骨瘤以及增强T1可见低级别软骨肉瘤[B];手部X片可见第2-5指[C-D]需要切除超过掌指关节的手指内生软骨瘤)

[参考文献]

Gregory TA, Taylor LP. Teaching NeuroImage: Histopathologically Confirmed Intracranial Enchondroma/Low-Grade Chondrosarcoma and IDH1-Mutated Diffuse Glioma in Ollier Disease. Neurology. 2021 Oct 26;97(17):e1747-e1748.

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    2022-08-11 医鸣惊人

    认真学习了

    0

  5. 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    2022-08-06 jktdtl
  8. 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