Satoh H, Nishiyama T, Horiguchi A, Nakashima J, Saito S, Murai M
Department of Urology, Keio University School of Medicine.
Nihon Hinyokika Gakkai Zasshi. 2000 Jun;91(6):562-4. doi: 10.5980/jpnjurol1989.91.562.
A case of Collet-Sicard Syndrome caused by skull base metastasis of prostate carcinoma is reported. A fifty-five years old man presenting multiple lymph node and bone metastases of prostate carcinoma was treated with LH-RH agonist and Flutamide, which induced transient decrease in serum PSA levels and size of lymph node metastases. After 8 months of the treatment, the patient started complaining headache, dysphagia and dysarthria. Brain CT and MRI demonstrated a soft tissue mass replacing left pyramidal bone and occipital bone around left jugular foramen. The tumor was diagnosed as skull base metastasis of the prostate carcinoma and was treated with 50Gy of radiation. The symptom improved after the radiation but died of the disease in 4 months. The autopsy revealed the skull base metastasis of the prostate carcinoma and the tumor was proved to be poorly differentiated adenocarcinoma, which was positively stained by anti-PSA antibody. The case showed cranial nerve palsy of IX to XII, which is usually called Collet-Sicard syndrome. This is the third case report of Collet-Sicard syndrome caused by the skull base metastasis of prostate carcinoma, and it is the first case in Japan.
报告一例由前列腺癌颅底转移引起的科莱-西卡尔综合征。一名55岁男性，患有前列腺癌的多处淋巴结和骨转移，接受了促黄体生成素释放激素（LH-RH）激动剂和氟他胺治疗，这导致血清前列腺特异抗原（PSA）水平和淋巴结转移灶大小短暂下降。治疗8个月后，患者开始出现头痛、吞咽困难和构音障碍。脑部CT和磁共振成像（MRI）显示一个软组织肿块取代了左侧锥体骨和左侧颈静脉孔周围的枕骨。该肿瘤被诊断为前列腺癌颅底转移，并接受了50Gy的放疗。放疗后症状有所改善，但4个月后死于该疾病。尸检发现前列腺癌颅底转移，肿瘤被证实为低分化腺癌，抗PSA抗体染色呈阳性。该病例表现为IX至XII颅神经麻痹，通常称为科莱-西卡尔综合征。这是第三例由前列腺癌颅底转移引起的科莱-西卡尔综合征病例报告，也是日本首例。
