Wen B C, Hussey D H, Clamon G H, Godersky J C
Department of Radiology, University of Iowa College of Medicine, Iowa City.
J Surg Oncol. 1992 Apr;49(4):266-9. doi: 10.1002/jso.2930490412.
Leptomeningeal carcinomatosis (LMC) is a rare complication following treatment for head and neck cancer. In this paper, we report a case of LMC following surgery and localized radiation therapy for an ethmoid carcinoma, in which laceration of the dura during craniofacial resection may have provided an access for cancer cells into the cerebrospinal fluid (CSF). As a result, the patient developed LMC manifested as multiple spinal nerve root involvement. The patient died 3 months after the diagnosis of LMC. To avoid this type of complication, special care must be taken to prevent tears in the dura during craniofacial resection. Also, we recommend CSF examination be performed prior to radical surgery if there is any suspicion of meningeal invasion.
柔脑膜癌病(LMC)是头颈部癌治疗后的一种罕见并发症。在本文中,我们报告了一例筛窦癌手术后行局部放射治疗后发生LMC的病例,其中颅面切除术中硬脑膜撕裂可能为癌细胞进入脑脊液(CSF)提供了途径。结果,患者发生了以多根脊神经根受累为表现的LMC。患者在LMC诊断后3个月死亡。为避免此类并发症,颅面切除术中必须特别注意防止硬脑膜撕裂。此外,如果怀疑有脑膜侵犯,我们建议在根治性手术前进行脑脊液检查。