Khalfallah M, Roche P H, Figarrela-Branger D, Malca S, Pellet W
Service de Neurochirurgie, Hôpital Sainte-Marguerite, Marseille.
Neurochirurgie. 1999 Sep;45(3):250-4.
We report a case of dural metastasis, detailing the neuroradiologic and therapeutic aspects. The clinical presentation was limited to a progressive left hemiparesis. Post-contrast CT scan revealed a heterogeneous high-density mass of the right fronto-parietal convexity. MRI demonstrated dural involvement mimicking meningioma. Chest X-ray showed a right lung opacity, suggesting the diagnosis of dural metastasis. Surgical resection was performed. Histology confirmed the diagnosis of dural metastasis from a poorly differentiated carcinoma. Treatment was completed with radiotherapy and chemotherapy. Dural metastases are rarely reported. A review of the literature revealed principally 2 radiological aspects: hemorrhagic effusion and tumor mass. The pathophysiology of dural metastases is still a subject of debate. Two mechanisms have been put forward involving venous and arterial dissemination. As radiological aspects are confusing, the diagnosis of dural metastasis should be evoked in patients with spontaneous hemorrhagic subdural effusion or a tumor mass involving the dura mater.
我们报告一例硬脑膜转移瘤病例，详述其神经放射学和治疗方面的情况。临床表现仅限于进行性左侧偏瘫。增强CT扫描显示右侧额顶叶凸面有一个不均匀的高密度肿块。MRI显示硬脑膜受累，类似脑膜瘤。胸部X线显示右肺有模糊影，提示硬脑膜转移瘤的诊断。进行了手术切除。组织学证实为低分化癌的硬脑膜转移。放疗和化疗完成了治疗。硬脑膜转移瘤鲜有报道。文献回顾主要揭示了两个放射学方面的表现：出血性积液和肿瘤肿块。硬脑膜转移瘤的病理生理学仍是一个有争议的话题。已经提出了两种机制，涉及静脉和动脉播散。由于放射学表现令人困惑，对于有自发性硬膜下出血性积液或累及硬脑膜的肿瘤肿块的患者，应考虑硬脑膜转移瘤的诊断。
