1 case of sickle spongiform hemangioma in the brain

Male, 60 years oldNo obvious cause appeared left face numbness for more than two years, the patient 1 week ago due to hand trauma admitted to the hospital full-body examination, laboratory and physical examination did not see obvious abnormalitiesMRI performance: the left forehead brain front fissure can be seen oval slightly longer T1, such as T2 signal shadow, size about 3.5 cm x 3.1 cm x 4.1 cm, the boundary is clear, enhanced scanning is significantly unevenly strengthened, adjacent to the meninges thickening, strengthening, the left ventricer front slightly pressured, the middle-line structure of the partial right (Figure 1,2A, 2B)Figure 1A to 1C tumors can be seen thickening blood vessel shadow, T1WI is slightly lower signal, T2WI signal is uneven, with the main signalFigure 2A, 2BT1WI enhancement indicates that the tumor is significantly unevenly strengthened, coronary T1WI enhancement lesions are closely related to the brain lesions
surgery and pathology: the excision of the intracranial occupancy lesions in the line of fissure, the surgery can be seen tumor sit on the left side of the brain, closely related to the brain, the tumor body blood supply is rich, the appearance is bright red, the texture is slightly strong, the tumor and surrounding brain tissue mildly adhered toPostoperative histopathological examination: tumor tissue consists of a large number of irregularly shaped vascular sinus cavity gaps, the size of the tube cavity varies, the endothelial differentiation mature (Figure 2c)Immune grouping: A4:EMA (-); Vimentin (-) ;PR (-); S-100 (-); GFAP (-); STAT6 (-) and Ki-67 (-)Diagnosis of spongiform hemangiomaFigure 2C visible tumor tissue is composed of irregular vascular sinus cavity, endothelial differentiation mature (HE, x 100)Discussedbrain-like spongiform hemangiomas (extracerebral spongiform ossanoma, ECHs) is a rare hidden cerebrovascular malformation, only 0.4% to 2% of all intracranial vascular malformations, clinical symptoms are mostly manifested as intracranial conjure effects of headache, resuscitation and cranial nerve paralysisThe growth site of the brain-type spongiform hemangioma is mostly related to sinus, most commonly in the sinus area of the cranial nest, a few can be located in the brain convex surface, cerebellum curtain and neck vein hole area, etc, the lesions that occur in the brain are very rare, no relevant cases have been reported in Chinathe main imaging characteristics of this lesions are as follows: 1) the lesions are single-haired substantial lumps, the boundary is clear, no calcification is found in the lump; ECHs in T2WI is more present as a high signal, and this case of the lesionT2WI is similar to the previous reports, combined with pathological results, which may be related to tumors rich in interstitial composition, collagen fiber At the same time, Kaqa and other studies believe that the vascular cavity and blood clots in the lesions can cause T2WI dot or bar low signal shadow, this performance is consistent with this case lesions in addition, Liu Xiang and so on by observing 12 cases of the cranial outer brain-like spongiform hemangioma found that angiography lesions are more common tumor-like staining; this case of lesions need to be identified with meningioma and hemangiocyma 1) Meningioma: common in middle-aged women, morphological rules, clear boundaries, MRI is such as T1, such as T2 signal, enhanced after the lesions strengthen edgy obvious, most of the visible "meningioma tail" signs; The MRS of the tumor is characterized by an elevated Cho peak, which can be used as a supplementary means of differential diagnosis, 2) vascular cell tumors are common in young women, mostly leaf-like, narrow substrates connected to the epidural, MRI signals are uneven, common airish hemangiography, tumor peripheral occupation effect is obvious, at the same time, tumors are aggressive, often destroy the bone adjacent matter