A 34-year-old man presented with a 3-week history of worsening headache and diplopia. A cranial computed tomography scan with findings consistent with a left frontal tumor prompted a referral to our institution. On admission, he was alert, oriented, and able to follow commands. The rest of his neurologic examination had unremarkable results, except for mild optic-disc swelling. The results of a metastatic workup with computed tomography were negative. Cranial magnetic resonance imaging showed a complex left frontal intraxial mass with heterogeneous enhancements. A prominent transmedullary vein consistent with the developmental venous anomaly (DVA) was also seen in the center of the mass (Figure 1A). A catheter angiogram confirmed the finding of a DVA, with the lesion appearing in the mid to late arterial phase (Figure 1B; Video). More importantly, the study demonstrated that the peritumoral brain parenchyma drained through the superior sagittal sinus rather than the DVA. Five days after admission, the patient underwent a left frontal craniotomy for resection of the tumor. A histopathologic examination revealed findings of a glioblastoma multiforme (Figure 2A and B). He was discharged within 2 days after surgery. Postoperative imaging demonstrated the adequate resection of both tumor and DVA.

一名34岁的男子有3周的头痛和复视恶化史。颅骨计算机断层扫描扫描发现与左额叶肿瘤相符，提示转诊到我们的机构。入院时，他机敏，有针对性，并能够遵守命令。除轻度视盘肿胀外，其余的神经系统检查结果均无异常。计算机断层扫描的转移检查结果为阴性。颅脑磁共振成像显示复杂的左额叶内轴团，并具有异质性增强。在肿块中心还可见到与发育静脉异常（DVA）相一致的突出的经髓静脉（图1A）。导管血管造影证实发现了DVA，病变出现在动脉的中晚期（图1B；视频）。更重要的是，研究表明，瘤周围脑实质通过上矢状窦而不是DVA排出。入院五天后，患者进行了左侧额叶开颅手术，以切除肿瘤。组织病理学检查显示多形性胶质母细胞瘤的发现（图2A和B）。他在手术后两天内出院。术后影像学检查显示肿瘤和DVA均已切除。