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NEJM:2型神经纤维瘤病中的双侧前庭神经鞘瘤-病例报道

2018-10-11 xing.T MedSci原创

双侧前庭神经鞘瘤是2型神经纤维瘤病的标志。在受影响的患者中,可能在其他颅神经和周围神经、脑膜瘤、室管膜瘤和星形细胞瘤上发展为神经鞘瘤。患者可能有患有2型神经纤维瘤病的父母,这是由NF2突变引起的。这些异常以常染色体显性方式遗传,尽管也可能发生新的突变。

患者为一名32岁的男性,因轻微的平衡困难和左耳听力损失而到神经外科就诊。该患者有2型神经纤维瘤病以及双侧听力传导通路肿瘤的家族史。

他既往没有与肿瘤相关的症状(例如,听力丧失或失衡),并且自16岁起就开始接受大脑的监视成像检查。对患者听力的评估发现左侧感觉神经性损失严重,右侧听力正常。给予增强剂后进行的脑磁共振成像发现两侧听力传导通路中存在肿瘤(左侧33×26×31mm,右侧32×28×30mm),小脑桥脑角延长,以及严重的脑干压迫。




双侧前庭神经鞘瘤是2型神经纤维瘤病的标志。在受影响的患者中,可能在其他颅神经和周围神经、脑膜瘤、室管膜瘤和星形细胞瘤上发展为神经鞘瘤。患者可能有患有2型神经纤维瘤病的父母,这是由NF2突变引起的。这些异常以常染色体显性方式遗传,尽管也可能发生新的突变。

该患者进行左侧肿瘤的左侧次全切除和立体定向放射外科治疗。在初次报告后的5年零11个月内,左耳严重的听力损失持续存在,但平衡困难这一问题已经解决。患者继续进行年度听力检查和大脑MRI检查,并且在随访时没有出现新的症状。

原始出处:

Antonio Meola,et al.Bilateral Vestibular Schwannomas in Neurofibromatosis Type 2.N Engl J Med 2018; https://www.nejm.org/doi/full/10.1056/NEJMicm1804944

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  8. [GetPortalCommentsPageByObjectIdResponse(id=2076450, encodeId=52ec20e645026, content=<a href='/topic/show?id=d7453259e86' target=_blank style='color:#2F92EE;'>#前庭神经#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32597, encryptionId=d7453259e86, topicName=前庭神经)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec37461, createdName=szhvet, createdTime=Thu Jan 03 06:40:00 CST 2019, time=2019-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2042014, encodeId=f1bd204201493, content=<a href='/topic/show?id=be0b1088e8' target=_blank style='color:#2F92EE;'>#2型神经纤维瘤病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1088, encryptionId=be0b1088e8, topicName=2型神经纤维瘤病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c48a270, createdName=Smile2680, createdTime=Tue Dec 18 06:40:00 CST 2018, time=2018-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1340175, encodeId=64bc13401e5aa, content=<a href='/topic/show?id=d0c3e4615f2' target=_blank style='color:#2F92EE;'>#神经鞘瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74615, encryptionId=d0c3e4615f2, topicName=神经鞘瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48732500158, createdName=12498c32m68暂无昵称, createdTime=Fri Oct 12 22:40:00 CST 2018, time=2018-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1387715, encodeId=c108138e71573, content=<a href='/topic/show?id=f210e72532e' target=_blank style='color:#2F92EE;'>#纤维瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77253, encryptionId=f210e72532e, topicName=纤维瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5fc62500009, createdName=12498474m30暂无昵称, createdTime=Fri Oct 12 22:40:00 CST 2018, time=2018-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1489761, encodeId=be3c1489e6104, content=<a href='/topic/show?id=5293e447259' target=_blank style='color:#2F92EE;'>#神经纤维#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74472, encryptionId=5293e447259, topicName=神经纤维)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=53f28597470, createdName=stfoxst, createdTime=Fri Oct 12 22:40:00 CST 2018, time=2018-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1522418, encodeId=7fcb15224189a, content=<a href='/topic/show?id=46223e39897' target=_blank style='color:#2F92EE;'>#双侧#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37398, encryptionId=46223e39897, topicName=双侧)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=741b11453403, createdName=wangbingxhy, createdTime=Fri Oct 12 22:40:00 CST 2018, time=2018-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1590546, encodeId=61e215905460e, content=<a href='/topic/show?id=1a13e725459' target=_blank style='color:#2F92EE;'>#纤维瘤病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77254, encryptionId=1a13e725459, topicName=纤维瘤病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fa7717811566, createdName=lixiao3332, createdTime=Fri Oct 12 22:40:00 CST 2018, time=2018-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=348994, encodeId=c08534899410, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfBfgWn9nXBgH1sNSiaOAKhsKpN40jDHQKqcRzovau5VibLvREN8uxnu9sKoScBicHSiaDMmbveibFdrBiaD4k4IOPwlG/0, createdBy=b5d11730951, createdName=Jackie Li, createdTime=Fri Oct 12 07:33:30 CST 2018, time=2018-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=348855, encodeId=5fea34885563, content=谢谢分享,学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/07/16/3b24606172648eea459125cb74754afe.jpg, createdBy=6c022216608, createdName=liumin1987, createdTime=Thu Oct 11 08:52:26 CST 2018, time=2018-10-11, status=1, ipAttribution=)]
    2018-10-12 Jackie Li

    学习

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=2076450, encodeId=52ec20e645026, content=<a href='/topic/show?id=d7453259e86' target=_blank style='color:#2F92EE;'>#前庭神经#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32597, encryptionId=d7453259e86, topicName=前庭神经)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec37461, createdName=szhvet, createdTime=Thu Jan 03 06:40:00 CST 2019, time=2019-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2042014, encodeId=f1bd204201493, content=<a href='/topic/show?id=be0b1088e8' target=_blank style='color:#2F92EE;'>#2型神经纤维瘤病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1088, encryptionId=be0b1088e8, topicName=2型神经纤维瘤病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c48a270, createdName=Smile2680, createdTime=Tue Dec 18 06:40:00 CST 2018, time=2018-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1340175, encodeId=64bc13401e5aa, content=<a href='/topic/show?id=d0c3e4615f2' target=_blank style='color:#2F92EE;'>#神经鞘瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74615, encryptionId=d0c3e4615f2, topicName=神经鞘瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48732500158, createdName=12498c32m68暂无昵称, createdTime=Fri Oct 12 22:40:00 CST 2018, time=2018-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1387715, encodeId=c108138e71573, content=<a href='/topic/show?id=f210e72532e' target=_blank style='color:#2F92EE;'>#纤维瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77253, encryptionId=f210e72532e, topicName=纤维瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5fc62500009, createdName=12498474m30暂无昵称, createdTime=Fri Oct 12 22:40:00 CST 2018, time=2018-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1489761, encodeId=be3c1489e6104, content=<a href='/topic/show?id=5293e447259' target=_blank style='color:#2F92EE;'>#神经纤维#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74472, encryptionId=5293e447259, topicName=神经纤维)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=53f28597470, createdName=stfoxst, createdTime=Fri Oct 12 22:40:00 CST 2018, time=2018-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1522418, encodeId=7fcb15224189a, content=<a href='/topic/show?id=46223e39897' target=_blank style='color:#2F92EE;'>#双侧#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37398, encryptionId=46223e39897, topicName=双侧)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=741b11453403, createdName=wangbingxhy, createdTime=Fri Oct 12 22:40:00 CST 2018, time=2018-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1590546, encodeId=61e215905460e, content=<a href='/topic/show?id=1a13e725459' target=_blank style='color:#2F92EE;'>#纤维瘤病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77254, encryptionId=1a13e725459, topicName=纤维瘤病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fa7717811566, createdName=lixiao3332, createdTime=Fri Oct 12 22:40:00 CST 2018, time=2018-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=348994, encodeId=c08534899410, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfBfgWn9nXBgH1sNSiaOAKhsKpN40jDHQKqcRzovau5VibLvREN8uxnu9sKoScBicHSiaDMmbveibFdrBiaD4k4IOPwlG/0, createdBy=b5d11730951, createdName=Jackie Li, createdTime=Fri Oct 12 07:33:30 CST 2018, time=2018-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=348855, encodeId=5fea34885563, content=谢谢分享,学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/07/16/3b24606172648eea459125cb74754afe.jpg, createdBy=6c022216608, createdName=liumin1987, createdTime=Thu Oct 11 08:52:26 CST 2018, time=2018-10-11, status=1, ipAttribution=)]
    2018-10-11 liumin1987

    谢谢分享,学习了。

    0

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