congenital tumor
Introduction
Introduction to congenital tumors Congenital tumors can be divided into craniopharyngioma, epithelioid tumors and germ cell tumors, of which craniopharyngioma is the most common congenital intracranial tumor. There are many different names depending on the location and histological features of the tumor, such as saddle cysts, epithelial tumors, epithelial cysts, squamous epithelioma, enamel tumors, and pituitary enamel tumors. Epithelioid tumors and skin tumors (dermoid cysts) originate from embryonic epitheliomas remaining in the brain. Epithelioid tumors only contain ectodermal components. The skin-like tumors contain two germ layer components, the ectoderm and mesoderm. The teratoma contains three germ layer components. Skin tumors and teratomas are rare. Germ cell tumors are also known as atypical teratomas. They used to be called pineal tumors. Tumors occur from embryonic cells, not from pineal parenchymal cells. basic knowledge Sickness ratio: 0.0001% Susceptible people: no specific population Mode of infection: non-infectious Complications: ataxia, epilepsy
Cause
Congenital tumor etiology
Epithelioid tumors and skin-like tumors (dermoid cysts) originate from embryonic epitheliomas remaining in the brain, epithelioid tumors contain only ectodermal components, and skin-like tumors contain ectoderm and mesoderm. Tumors contain three germ layer components, skin tumors and teratomas are rare, germ cell tumors are also known as atypical teratomas, which used to be called pineal tumors, tumors originate from embryonic cells, not pineal parenchyma. cell.
Prevention
Congenital tumor prevention
After the operation, the visual field of vision should be evaluated to grasp the intracranial changes after surgery. Generally, the patient's postoperative mental condition is good. If the visual field of vision is lower than before surgery, it is usually caused by surgical damage; if suddenly Sexual changes, consider whether there is bleeding in the brain, notify the doctor in time, and make a treatment.
Complication
Congenital tumor complications Complications, ataxia, epilepsy
The complications of this disease are complex and diverse, mainly depending on the location of the tumor, manifested as cerebellar cerebral horn syndrome, facial sensation decreased, masticatory muscle atrophy, cerebral hemisphere tumor often has seizures, mental symptoms and hemiparesis; cerebellum Tumors have a number of cerebellar symptoms such as ataxia, and individual occipital sinuses may also be present under the occipital.
Symptom
Congenital tumor symptoms Common symptoms Neuropathic pain Dizziness Giant optic nerve atrophy Optic papilled edema Precocious hearing loss Visual impairment Eyeball tremor Increased intracranial pressure
(a) craniopharyngioma
It is a relatively common intracranial tumor, accounting for 5.1% to 6.5% of intracranial tumors, accounting for 60% of congenital tumors, accounting for 30% of tumors in saddle area, and the first in children with saddle area tumors. The second in the sellar tumor is second only to the pituitary tumor. It is more common in men. The male to female ratio is about 2:1. It can occur at any age, and is more common in young people and children. About 55% and 5 years old, about 55%, 80% The above is under 40 years old.
(two) epithelioid tumor
Symptoms are mostly slow to develop, ranging from symptoms to treatment for several decades. On average, about 5 years, the symptoms and signs of tumors in various parts are as follows:
(1) Cerebellar ganglion tumor: The first symptom is trigeminal neuralgia, accounting for 2/3, and the late manifestation is cerebellar cerebral horn syndrome.
(2) Middle cranial fossa tumor: mainly manifested as symptoms of trigeminal nerve damage, common facial sensation diminished, weak masticatory muscle atrophy.
(3) Tumors in the brain parenchyma: According to the location of the tumor, the corresponding symptoms occur. Cerebral hemisphere tumors often have seizures, mental symptoms and hemiparesis. Cerebellar tumors often have ataxia and other cerebellar symptoms. Individual subpills may also have Fur sinus.
(4) ventricle tumor: early asymptomatic or only mild headache and dizziness, when the tumor grows clogged cerebrospinal fluid circulation, there is an increase in intracranial pressure symptoms, when invading the surrounding brain tissue, there may be adjacent brain symptoms.
(5) Cancer in the sellar region: The early manifestations are mainly slow-developing vision loss, which can cause optic atrophy over time.
(6) Epidural tumor: It originates from the skull barrier, and the scalp mass can be seen in the outward growth. When the tumor grows up, the intracranial pressure can be increased, and most of the lesions are not limited.
(3) Germ cell tumor
The course of the disease is short, from the onset to the short visit for 10 days, the elderly can reach 2 years, the average is 7 to 8 months, mainly manifested as symptoms of increased intracranial pressure, local symptoms and endocrine symptoms, because the tumor is easy to block the water conduit, Caused by hydrocephalus, headache, vomiting, papilledema and other symptoms and signs of increased intracranial pressure, early headache is paroxysmal, mainly in the frontal sac, progressive exacerbation.
Tumors located in the pineal body are easy to oppress the midbrain quadriplex, especially in the upper humerus, resulting in binocular upper visual disturbance, a few with lower vision disorder, bilateral pupillary light reflexes are slow or disappear, and the inferior colliculus and medial geniculate body are affected. When pressure occurs, tinnitus occurs, bilateral hearing loss, tumors through the cerebellar incision backward compression of the cerebellar upper axilla and the binding arm, then produce ataxia and nystagmus, etc., the tumor located in the saddle can produce optic chiasm, optic nerve Symptoms of compression, hemianopia, primary optic atrophy, vision loss, etc.
Because the pineal cells are damaged by tumor compression, the prominent manifestation is precocious puberty, which is more common in male and female patients, and the genitals and secondary sexual characteristics develop prematurely.
Examine
Examination of congenital tumors
(a) craniopharyngioma:
(1) Determination of endocrine function: In patients with hypopituitarism, the basal metabolic rate is reduced, and the glucose tolerance is often low-level curve or delayed, and various hormones such as T3, T4, FSH, and LH can be reduced.
(2) Skull X-ray film: 80%90% of patients have abnormal changes in the head plain film. The main manifestations are: 1 saddle area calcium spot, 2 saddle change; the saddle is often expanded in a basin shape, and a few can also be spherical. Enlargement, 3 intracranial hypertension increased, about 60% of patients.
(3) CT scan of the brain: the outline of the tumor is displayed in the saddle area. The tumor parenchyma is mostly a slightly high density or iso-density image. The calcified tissue is a high-density image. The cystic cavity is low-density. Different degrees of image enlargement, with calcification, cystic cavity and enhanced image enhancement, can generally be diagnosed.
(2) Epithelioid tumors:
(1) Skull X-ray: There is often an increase in intracranial pressure.
(2) CT scan of the brain: it is shown as a low-density image. Generally, the image is not enhanced after the contrast agent is injected, and the visible edges of the individual are slightly enhanced.
(3) Germ cell tumors :
(1) Skull x-ray plain film: generally showed increased intracranial pressure, about 40% of abnormal pineal calcification, calcification in children, or adult calcification more than 1 cm, are pathological.
(2) CT scan: Most of them show high-density images. They can also be of equal density, common calcification, enlargement of ventricles on both sides, and enhanced image after contrast agent injection.
Diagnosis
Diagnosis and diagnosis of congenital tumors
Diagnosis of epithelioid tumor: The patient is younger and has a slower progression of intracranial lesions. Although the signs are more but less severe, the disease should be considered. Most of the patients with trigeminal neuralgia are caused by this disease.
