CT与MR诊断鞍区原发性小圆细胞性未分化肉瘤的临床案例分析

程少磊; 彭迪; 王琼; 胡兴荣; 余美英

doi:10.15953/j.ctta.2022.252

CT与MR诊断鞍区原发性小圆细胞性未分化肉瘤的临床案例分析

程少磊^{1, 2,},
彭迪^{1, 2},
王琼^{2, 3},
胡兴荣^2, ,,
余美英²

1.
湖北医药学院, 湖北十堰442000
2.
恩施土家族苗族自治州中心医院医学影像科, 湖北恩施445000
3.
湖北民族大学医学部, 湖北恩施445000

详细信息

作者简介:
程少磊: 男，湖北医药学院放射影像学专业硕士研究生，主要从事神经影像学研究，E-mail：1095298332@qq.com

通讯作者:
胡兴荣: 硕士，恩施土家族苗族自治州中心医院放射影像科副主任、主任医师、教授，湖北医药学院及湖北民族大学硕士研究生导师，主要研究方向为放射影像学，E-mail：xrh_cct@126.com

中图分类号: R 814；R 445
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出版历程
- 收稿日期: 2022-12-18
- 修回日期: 2023-02-21
- 录用日期: 2023-03-27
- 网络出版日期: 2023-04-11
- 发布日期: 2023-07-30

Primary Undifferentiated Small Round Cell Sarcoma of Sellar Region: A Case Report and Literature Review

CHENG Shaolei^{1, 2,},
PENG Di^{1, 2},
WANG Qiong^{2, 3},
HU Xingrong^2, ,,
YU Meiying²

1.
Hubei University of Medicine, Shiyan 442000, China
2.
Department of Medical Imaging, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi 445000, China
3.
Medical School, HuBei Minzu University, Enshi 445000, China

摘要

摘要: 目的：探讨鞍区原发性小圆细胞性未分化肉瘤的临床表现、病理特征及影像特点，以提高对该病的影像诊断及鉴别诊断能力。方法：回顾性分析1例经手术病理证实为鞍区原发性小圆细胞性未分化肉瘤的临床病理特征、CT及MR表现，并复习文献。结果：CT平扫示鞍区偏右侧呈稍低密度影，增强欠均匀强化，并累及邻近颅骨；MRI示T1WI呈低信号，T2WI、液体衰减反转恢复（FLAIR）呈略高信号，扩散加权成像（DWI）序列上呈高信号，信号欠均匀；增强病灶较明显强化，边缘较光整，邻近蝶鞍后床突可见骨质破坏。结论：鞍区原发性小圆细胞未分化肉瘤罕见，其临床和影像表现无明显特异性，确诊仍需依靠病理组织学检查。
- CT诊断 /
- 鞍区 /
- 未分化/未分类软组织肉瘤
Abstract: Objective: This study aimed to investigate the clinical, pathological, and imaging features of primary undifferentiated small round cell sarcoma of the sellar region to improve the ability of imaging and differential diagnosis. Methods: The clinicopathological features and computed tomography (CT) and magnetic resonance imaging (MRI) manifestations of a case with primary undifferentiated small round cell sarcoma of the sellar region confirmed by surgery and pathology were retrospectively analyzed, and the literature was reviewed and summarized. Results: CT showed a node in the right sellar region, reinforcement under-uniform reinforcement and affects adjacent skull; MRI showed homogeneous hypointensity on the T1-weighted image, hyperintense on the T2-weighted image, fluid-attenuated inversion recovery, and diffusion-weighted imaging; and significantly reinforcement with smooth margin on reinforcement scanning. Bone destruction was seen near the posterior clinoid process of the sella turcica. Conclusion: Primary undifferentiated small round cell sarcoma of the sellar region is rare, and its clinical and imaging findings are not significantly specific. Therefore, the diagnosis requires histopathological examination.
- CT /
- sellar region /
- undifferentiated/unclassified soft tissue sarcoma

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图 1 颅脑CT

Figure 1. Cranial CT

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图 2 颅脑MRI

Figure 2. MRI of the cranial brain

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图 3 垂体MRI

Figure 3. MRI of hypophysis

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图 4 病理及免疫组化

Figure 4. Pathology and immunohistochemistry

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图 5 术后5月，右侧桥前池明显强化软组织信号结节

Figure 5. At 5 months after surgery, the right anterior pontine pool significantly enhanced the soft tissue signal nodules

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参考文献(12)

[1]	SAREEN P, CHHABRA L, TRIVEDI N. Primary undifferentiated spindlecell sarcoma of sella turcica: Successful treatment with adjuvant temozolomide[J]. BMJ Case Reports, 2013, 2013. pii: bcr201300934.
[2]	王坚, 朱雄增. 软组织肿瘤病理学[M]. 2版. 北京: 人民卫生出版社, 2017: 1380-1381. WANG J, ZHU X Z. Soft-tissue tumor pathology[M]. The 2 ed. Beijing: People's Health Publishing House, 2017: 1380-1381. (in Chinese).
[3]	FLETCHER C D M, BRIDGE J A, HOGENDOORN P C W, eds. WHO classification of soft tissue and bone tumours[M]. 4ed, Lyon: IARC Press; 2013: 236-238.
[4]	HUANG B Y, CASTILLO M. Nonadenomatous tumors of the pituitary and sella turcica[J]. Topics in Magnetic Resonance Imaging, 2005, 16(4): 289−299. doi: 10.1097/01.rmr.0000224685.83629.18
[5]	LOPES M B, LANZINO G, CLOFT H J, et a1. Primary fibrosarcoma of the sella unrelated to previous radiation therapy[J]. Modern Pathology, 1998, ll(6): 579−584.
[6]	SCHULTZ A B, BRAT D J, OYESIKU N M, et a1. Intrasellar pituicytoma in a patient with other endocrine neoplasms[J]. Archives of Pathology & Laboratory Medicine, 200 l, 125(4): 527-530.
[7]	SHINOJIMA N, OHTA K, YANO S, et a1. Myofibroblastoma in the suprasellar region: Case report[J]. Journal of Neurosurgery, 2002, 97(5): 1203−1207. doi: 10.3171/jns.2002.97.5.1203
[8]	MENA H, RIBAS J L, PEZESHKPOUR G H, et a1. Hemangiopericytoma of the central nervous system: A review of 94 cases[J]. Human Pathology, 1991, 22(1): 84−91. doi: 10.1016/0046-8177(91)90067-Y
[9]	MANORANJAN B, SYRO L V, SCHEITHAUER B W, et a1. Undifferentiated sarcoma of the sellar region[J]. Endocrine Pathology, 2011, 22(3): 159−164. doi: 10.1007/s12022-011-9166-7
[10]	ALPERT T E, HAHN S S, CHUNG C T, et a1. Successful treatment of spindle cell sarcoma of the sella turcica: Case report[J]. Journal of Neurosurgery, 2002, 97(S5): 438−440.
[11]	ZHONG J, LI S T, YAO X H, et a1. An intrasellar rhabdomyosarcoma misdiagnosed as pituitary adenoma[J]. Surgical Neurology, 2007, 68(S2): S29−33.
[12]	张广健, 常建勇, 谢英亮, 等. 神经内镜下切除鞍区原发性未分化肉瘤一例并文献复习[J]. 中华神经外科杂志, 2017,33(10): 1070−1071. ZHANG G J, CHANG J Y, XIE Y L, et al. Neuroendoscopic resection of primary undifferentiated sarcoma in the sellar region: A case report and literature review[J]. Chinese Journal of Neurosurgery, 2017, 33(10): 1070−1071. (in Chinese).