Thompson Eric M, Sather Michael D, Reyes Christine A, Long Douglas J
Department of Neurosurgery, University of Nebraska Medical Center, Omaha, NE 68198-2035, USA.
Surg Neurol. 2007 Aug;68(2):233-8. doi: 10.1016/j.surneu.2006.08.079. Epub 2007 May 29.
Thymic carcinoma is an uncommon malignant tumor of the anterior mediastinum. Meningeal metastasis from this type of neoplasm is extraordinarily rare and the prognosis is abysmal.
This article presents the case of a 45-year-old man with known metastatic thymic carcinoma who presented with intractable headaches. An MRI scan was highly suggestive of a meningioma, and it was initially suspected that this patient had 2 primary tumors. Surgical resection of the mass both demonstrated a metastatic thymic lesion and ameliorated the patient's quality of life.
The authors report a case of intracranial meningeal metastasis from a lymphoepithelioma-like poorly differentiated metastatic thymic carcinoma, which was treated by resection and WBRT. A review of the current literature revealed no other cases of this uncommon alhistologic subtype of thymic carcinoma metastatic to the cranium. The incidence, histologic classification of subtypes, and treatment are discussed. This case also illustrates the importance of maintaining a high degree of suspicion for a metastasis in patients with known primary malignancy who present with an MRI highly suspicious for meningioma.
胸腺癌是前纵隔一种罕见的恶性肿瘤。这种肿瘤发生脑膜转移极为罕见，预后极差。
本文介绍了一名45岁已知有转移性胸腺癌的男性患者，其出现顽固性头痛。磁共振成像（MRI）扫描高度提示为脑膜瘤，最初怀疑该患者有两种原发性肿瘤。肿块的手术切除既证实为转移性胸腺病变，又改善了患者的生活质量。
作者报告了一例淋巴上皮瘤样低分化转移性胸腺癌发生颅内脑膜转移的病例，该病例通过手术切除和全脑放疗（WBRT）进行治疗。对当前文献的回顾显示，没有其他关于这种罕见的胸腺癌组织学亚型转移至颅骨的病例。文中讨论了其发病率、亚型的组织学分类及治疗方法。该病例还说明了对于已知有原发性恶性肿瘤且MRI高度怀疑为脑膜瘤的患者，高度怀疑有转移的重要性。
