๋ฉ”์ธ ์ฝ˜ํ…์ธ ๋กœ ๊ฑด๋„ˆ๋›ฐ๊ธฐ
์ฆ๋ก€ #1
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ํ™˜์ž ์ •๋ณด: 5 ์„ธ, ์—ฌ์„ฑ
์ ์‘์ฆ: ๋‘ํ†ต, ๊ธฐ๋ฉด

์ฆ๋ก€ #1

๋ฌด๋ฃŒ
๋ชจ๋‘ ๋ณด๊ธฐ

์†Œ๊ฒฌ

CT

MRI

์ฃผ์„์ด ์žˆ๋Š” ์ด๋ฏธ์ง€ ๋ฐ ์ผ๋Ÿฌ์ŠคํŠธ

Midline posterior fossa mass with a superior solid component (red arrow) and inferior peripherally-enhancing cystic component (yellow arrow).

Midline posterior fossa mass with a superior solid component (red arrow) and inferior peripherally-enhancing cystic component (yellow arrow).

Associated obstructive hydrocephalus with subependymal edema (red arrows).

Associated obstructive hydrocephalus with subependymal edema (red arrows).

์ง„๋‹จ

๋ชจ์–‘์„ธํฌ ์„ฑ์ƒ์„ธํฌ์ข…

์ฃผ์š” ์˜์ƒ ์†Œ๊ฒฌ

  • "๋‚ญ์ข…๊ณผ ๊ฒฐ์ ˆ" ์†Œ๊ฒฌ์ด ์ „ํ˜•์ ์ด์ง€๋งŒ, ์†Œ์ˆ˜์˜ ์ข…์–‘์€ ๋‚ญ์„ฑ ์„ฑ๋ถ„์„ ๋ณด์ด์ง€ ์•Š์Šต๋‹ˆ๋‹ค
  • ๊ณ ํ˜• ์„ฑ๋ถ„์€ ์ผ๋ฐ˜์ ์œผ๋กœ CT์—์„œ ๋‡Œ์‹ค์งˆ๋ณด๋‹ค ์ €์Œ์˜์ด๊ณ , T2 ๊ณ ์‹ ํ˜ธ๊ฐ•๋„์ด๋ฉฐ, ๊ท ์ผํ•˜๊ฒŒ ์กฐ์˜์ฆ๊ฐ•๋˜๊ณ , ํ™•์‚ฐ ์ œํ•œ์„ ๋ณด์ด์ง€ ์•Š์Šต๋‹ˆ๋‹ค
  • ๋‚ด๋ถ€ ์ถœํ˜ˆ์€ ๋“œ๋ญ…๋‹ˆ๋‹ค
  • ์„ํšŒํ™”๋Š” ์ผ๋ฐ˜์ ์œผ๋กœ ๊ด€์ฐฐ๋˜์ง€ ์•Š์Šต๋‹ˆ๋‹ค

๊ฐ๋ณ„์ง„๋‹จ

  • ๋‡Œ์‹ค๋ง‰์ข… - ์†Œ์•„์—์„œ ์ œ4๋‡Œ์‹ค์— ํ˜ธ๋ฐœํ•˜๋Š” ๊ฐ•ํ•˜๊ฒŒ ์กฐ์˜์ฆ๊ฐ•๋˜๋Š” ์ข…์–‘์œผ๋กœ, ๋” ๊ฐ€์†Œ์ ์ธ ๊ฒฝํ–ฅ์ด ์žˆ์œผ๋ฉฐ(Luschka ๊ณต์„ ํ†ตํ•ด ์ข…์–‘์ด ๋Œ์ถœํ•˜๋Š” ํŠน์ง•์  ์†Œ๊ฒฌ ํฌํ•จ) ๋‚ญ์„ฑ ์„ฑ๋ถ„์ด ์ ์€ ๊ฒฝํ–ฅ์ด ์žˆ์Šต๋‹ˆ๋‹ค
  • ์ˆ˜๋ชจ์„ธํฌ์ข… - ๊ฐ•ํ•˜๊ฒŒ ์กฐ์˜์ฆ๊ฐ•๋˜๋ฉฐ, ํ”ํžˆ ์ •์ค‘์„  ํ›„๋‘๊ฐœ์™€์— ์œ„์น˜ํ•˜๋Š” ์ข…์–‘์œผ๋กœ, ๋” ์–ด๋ฆฐ ๋‚˜์ด(3-9์„ธ)์— ๋ฐœํ˜„ํ•˜๋ฉฐ ์ „ํ˜•์ ์œผ๋กœ ํ™•์‚ฐ ์ œํ•œ์„ ๋™๋ฐ˜ํ•ฉ๋‹ˆ๋‹ค
  • ํ˜ˆ๊ด€๋ชจ์„ธํฌ์ข… - ์—ญ์‹œ "๋‚ญ์ข…๊ณผ ๊ฒฐ์ ˆ" ์ข…์–‘์ด์ง€๋งŒ, ์„ฑ์ธ๊ณผ von Hippel Lindau ๋ณ‘ ํ™˜์ž์—์„œ ๋” ํ”ํ•ฉ๋‹ˆ๋‹ค
  • ๊ณ ๋“ฑ๊ธ‰ ๊ต์ข… - ๋” ํฐ ์†Œ์•„์—์„œ ๋ฐœ์ƒํ•˜๋Š” ๊ฒฝํ–ฅ์ด ์žˆ์œผ๋ฉฐ, JPA๋ณด๋‹ค ๋” ์ด์งˆ์ ์ด๊ณ  ๊ฒฝ๊ณ„๊ฐ€ ๋ถˆ๋ช…ํ™•ํ•œ ๊ฒฝ์šฐ๊ฐ€ ๋งŽ์Šต๋‹ˆ๋‹ค. ๋˜ํ•œ, JPA์™€ ๋‹ฌ๋ฆฌ ๋‡Œ์ฒ™์ˆ˜์•ก ํŒŒ์ข… ๊ฒฝํ–ฅ์ด ์žˆ์Šต๋‹ˆ๋‹ค

๊ณ ์ฐฐ

  • ์—ฐ์†Œ์„ฑ ๋ชจ์–‘์„ธํฌ ์„ฑ์ƒ์„ธํฌ์ข…(JPA)์€ ์†Œ์•„์—์„œ ๊ฐ€์žฅ ํ”ํ•œ ํ›„๋‘๊ฐœ์™€ ์ข…์–‘์œผ๋กœ, 5-13์„ธ ์‚ฌ์ด์— ํ˜ธ๋ฐœํ•ฉ๋‹ˆ๋‹ค
  • JPA๋Š” WHO 1๋“ฑ๊ธ‰ ์ข…์–‘์ž…๋‹ˆ๋‹ค
  • ๋Œ€๋ถ€๋ถ„์˜ ํ›„๋‘๊ฐœ์™€ JPA๋Š” ์‚ฐ๋ฐœ์„ฑ์ด์ง€๋งŒ, ์‹œ์‹ ๊ฒฝ ๊ต์ข…(OPG)์€ ์‹ ๊ฒฝ์„ฌ์œ ์ข…์ฆ 1ํ˜•๊ณผ ๊ฐ•ํ•œ ์—ฐ๊ด€์„ฑ์ด ์žˆ์Šต๋‹ˆ๋‹ค

ํ•ต์‹ฌ ํฌ์ธํŠธ

  • ์†Œ์•„์˜ ํ›„๋‘๊ฐœ์™€์—์„œ "๋‚ญ์ข…๊ณผ ๊ฒฐ์ ˆ" ์ข…๊ดด ๋˜๋Š” ์กฐ์˜์ฆ๊ฐ•๋˜๋Š” ์ข…๊ดด๋ฅผ ๋ฐœ๊ฒฌํ•˜๋ฉด JPA๋ฅผ ์ƒ๊ฐํ•˜์‹ญ์‹œ์˜ค
  • ์‹œ์‹ ๊ฒฝ ๊ต์ข…๊ณผ NF1 ์‚ฌ์ด์— ๊ฐ•ํ•œ ์—ฐ๊ด€์„ฑ์ด ์žˆ์Šต๋‹ˆ๋‹ค

์ฐธ๊ณ ๋ฌธํ—Œ

  • Poretti A, Meoded A, Huisman TAGM. Neuroimaging of pediatric posterior fossa tumors including review of the literature. J Magn Reson Imaging 2012; 35(1): 32-47.

    • ์‚ฌ์ดํŠธ ํ”ผ๋“œ๋ฐฑ

    ์—ฌ๋Ÿฌ๋ถ„์˜ ํ”ผ๋“œ๋ฐฑ์€ CaseStacks ๊ฐœ์„ ์— ๋„์›€์ด ๋ฉ๋‹ˆ๋‹ค. ์˜๊ฒฌ, ์ œ์•ˆ ๋˜๋Š” ๋ฐœ์ƒํ•œ ๋ฌธ์ œ๋ฅผ ๊ณต์œ ํ•ด ์ฃผ์„ธ์š”.

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