筛窦颅内沟通型巨大皮样囊肿1例并文献复习

A case of huge dermoid cyst of ethmoid sinus-intracranial communication and literature review

目的探讨筛窦颅内沟通型巨大皮样囊肿的临床特点与外科治疗。方法回顾分析1例筛窦颅内巨大皮样囊肿患者的临床资料,并结合相关文献进行复习。结果患者男,58岁,因“左侧肢体乏力4年,进行性加重2年”入院。入院诊断为筛窦颅内沟通巨大肿瘤,考虑畸胎瘤可能,全麻下行右侧扩大翼点入路肿瘤切除术,病理示皮样囊肿,术后无并发症,随访1年,病变无复发。结论筛窦颅内巨大皮样囊肿比较少见,临床上注意与畸胎瘤及表皮样囊肿的鉴别,治疗首选外科手术,术中、术后采取措施预防无菌性脑膜炎,因病变侵犯颅底,要多学科协作,注意颅底修复重建预防脑脊液漏。

Objective To investigate the clinical characteristics and surgical treatment of huge dermoid cyst in ethmoid sinus-intracranial communication.Methods The clinical data of a patient with ethmoid sinus-intracranial huge dermoid cyst were analyzed retrospectively and the related literature were reviewed.Results A 58-year-old male patient was admitted with“left limb weakness for 4 years and progressive aggravation for 2 years”.The patient was diagnosed as a huge tumor of ethmoid sinus-intracranial communication,and the possibility of teratoma was considered.Tumor resection was performed under general anesthesia through the right enlarged pteral approach,and the pathology showed dermoid cyst.There were no postoperative complications.After 1 year follow-up,there was no recurrence of tumor.Conclusions Large ethmoid sinus-intracranial dermoid cyst is relatively rare,so clinical attention should be paid to the differentiation from teratoma and epidermoid cyst,and surgical operation is the first choice for treatment.Intraoperative and postoperative measures should be taken to prevent aseptic meningitis.Due to tumor invasion of skull base,multidisciplinary cooperation should be paid attention to repair and reconstruction of skull base to prevent cerebrospinal fluid leakage.