Yamamoto Akihito, Takahashi Kazuhisa, Morio Yoshiteru, Gunji Yoko, Iwakami Naoko, Kajiyama Yuichiro, Yoshioka Masataka, Miura Kayo, Suzuki Tsutomu, Ohwada Akihiko, Sato Koichi, Fukuchi Yoshinosuke
Department of Respiratory Medicine, Juntendo University School of Medicine.
Nihon Kokyuki Gakkai Zasshi. 2005 Mar;43(3):139-43.
We evaluated diagnosis and treatment of four cases of meningeal carcinomatosis associated with primary lung cancer: case 1; small cell carcinoma (64 years old), case 2; small cell carcinoma (50 years old), case 3; adenocarcinoma (53 years old), and case 4; adenocarcinoma (55 years old). Determination of tumor markers in cerebrospinal fluid (CSF) together with the MRI findings that Gd-DTPA-enhanced T1-weighted image showing high intensity signal along the spinal cord was clinically useful in the diagnosis of meningeal carcinomatosis. Two of four patients received intrathecal chemotherapy and/or CSF drainage through Ommaya-Reservoir, resulting in dramatic improvement of various symptoms such as motor weakness and vesicorectal disorder. Intrathecal chemotherapy and placement of an Ommaya-Reservoir for CSF drainage should be considered to provide better Quality of Life (QOL) when patient can tolerate it.
我们评估了4例与原发性肺癌相关的脑膜癌病的诊断和治疗情况：病例1为小细胞癌（64岁），病例2为小细胞癌（50岁），病例3为腺癌（53岁），病例4为腺癌（55岁）。脑脊液（CSF）中肿瘤标志物的测定以及MRI表现（钆喷酸葡胺增强T1加权图像显示脊髓沿线高强度信号）在脑膜癌病的诊断中具有临床实用性。4例患者中有2例接受了鞘内化疗和/或通过Ommaya储液器进行脑脊液引流，各种症状如运动无力和膀胱直肠功能障碍得到显著改善。当患者能够耐受时，应考虑鞘内化疗和放置Ommaya储液器进行脑脊液引流，以提高生活质量（QOL）。
