鼻腔鼻窦恶性脑膜瘤1例

Malignant meningioma in nasal cavity and paranasal sinuses:a case report

1病例报告 患者,女,50岁,因＂反复右侧头痛5年,加重2个月＂入院。头痛以右前额沉重感为主,无鼻出血、流涕、打喷嚏、嗅觉、视力减退等。入院体检：右侧中鼻道可见灰白色肿物,表面光滑,血管丰富。2014年8月27日行鼻咽部MRI示：右侧鼻腔内（富血供）占位性病变,大小约为21.5 mm×25.5mm×37.0 mm,边界清,考虑纤维血管瘤可能性大。

Summary Female patients, 50 years old, have a recurrent unilateral aggravating headache for 5 years. With- out runny nose, sneezing, nasal hemorrhage, smell or vision loss. Prefessional examination= there is a visible hoar neoplasm in the right middle nasal meatusWith smooth surface and rich in vascular . The nasopharyngeal MRI shows that there is a occupancy lesion in the right nasal cavity and sinuses, well-demarcated, about 21.5 mm × 25.5 mm×37.0 mm. Angiofibroma is the most likely diagnosis. Postoperative pathological section shows that tumor are hypercellular, which contains big nucleus. Cells are spindle or short fusiform shape, there are stripes and nuclear division in some cells. There are vortex structures in partial region. Immunohistochemical examination shows= CD34（＋＋）, Ki-67（〈5%）, CD68（-）,Des （-）, NSE（＋）, S-100（＋＋）, SMA（-）, EMA （＋）. Histopathologic diagnosis： atypical meningioma, some were differentiated to rhabdoid meningioma. The final diag- nosis is malignant meningioma in nasal cavity and paranasal sinuses.