Kuo M F, Tu Y K, Lin S M
Department of Surgery, National Taiwan University Hospital, Taipei, R.O.C.
J Formos Med Assoc. 1992 Oct;91(10):1010-2.
Solitary cerebellar metastatic tumors are rarely reported in the literature. We reviewed 240 posterior fossa tumors treated in the past eight years. There were 11 cases of solitary metastases in the cerebellum. The primary tumor was lung cancer in five cases and breast carcinoma in two cases; the remaining three cases had colon cancer, nasopharyngeal carcinoma (NPC) and Ewing's sarcoma, respectively. All patients underwent craniectomy and gross total excision of the tumor. Seven patients survived less than one year, two cases died in the second year, and one case of NPC survived for more than two years. The only survival is a case of Ewing's sarcoma who underwent surgery 14 months ago. The symptoms and signs of all patients improved satisfactorily after surgery. Four patients received postoperative irradiation to the posterior fossa and two cases of lung cancer had a thoracotomy for the primary lung lesion; however, the survival period was not prolonged. We suggest that a cancer patient or a patient in the fifth to seventh decades of life presenting headache, gait disturbance and vomiting should promptly undergo a computed tomography (CT) scan of the head. In selected cases, surgical intervention for solitary metastatic tumors in the tiny posterior fossa may be the best initial treatment. Adjuvant therapies should then be added according to the type of tumor.
孤立性小脑转移瘤在文献中鲜有报道。我们回顾了过去八年中治疗的240例后颅窝肿瘤。其中有11例小脑孤立性转移瘤。原发肿瘤为肺癌5例，乳腺癌2例；其余3例分别为结肠癌、鼻咽癌（NPC）和尤因肉瘤。所有患者均接受了颅骨切除术并肿瘤全切。7例患者存活时间不到一年，2例在第二年死亡，1例鼻咽癌患者存活超过两年。唯一存活的是14个月前接受手术的1例尤因肉瘤患者。所有患者术后症状和体征均有满意改善。4例患者术后接受了后颅窝放疗，2例肺癌患者因原发性肺部病变接受了开胸手术；然而，生存期并未延长。我们建议，出现头痛、步态障碍和呕吐的癌症患者或5至70岁的患者应及时进行头部计算机断层扫描（CT）。在某些病例中，对微小后颅窝孤立性转移瘤进行手术干预可能是最佳的初始治疗方法。然后应根据肿瘤类型添加辅助治疗。
