Knipping S, Heider C, Musil A, Bloching M B, Kösling S
Universitätsklinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Kopf - und Halschirurgie der Martin-Luther-Universität Halle-Wittenberg, Halle/Saale, Germany.
HNO. 2009 Jul;57(7):725-8. doi: 10.1007/s00106-008-1673-6.
Tumours and metastases of the lateral skull base are rare findings. Clinically, the progressive involvement of ipsilateral cranial nerves is important.
A 69-year-old man presented with headache and palsies of the facial nerve and nerve VI. Furthermore, he had hearing loss and hypaesthesia of the trigeminal nerve (V3). Four months previously, laser therapy for carcinoma of the trachea (cT4 cN3 cM0) had been done. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed an intrapetrosal mass with destruction of the lateral skull base. The findings suggested a metastasis of the tracheal carcinoma. We performed a mastoidectomy with specimen collection, and the pathological analysis revealed infiltration of a squamous cell carcinoma. The patient died within 3 weeks after radiotherapy with palliative intention despite malignant progression.
The diagnosis and therapy of metastases to the lateral skull base is an interdisciplinary challenge. CT and MRI scans are essential for planning further procedures. In cases of headache and cranial nerve palsies, a metastasis to the lateral skull base must be considered in the differential diagnosis.
侧颅底肿瘤和转移瘤较为罕见。临床上,同侧脑神经的进行性受累情况很重要。
一名69岁男性出现头痛、面神经和展神经麻痹。此外,他还伴有听力丧失和三叉神经(V3)感觉减退。四个月前,该患者已接受气管癌(cT4 cN3 cM0)激光治疗。计算机断层扫描(CT)和磁共振成像(MRI)显示岩骨内有肿块,侧颅底骨质破坏。这些表现提示为气管癌转移。我们进行了乳突切除术并采集标本,病理分析显示为鳞状细胞癌浸润。尽管有恶性进展,但患者在姑息性放疗后3周内死亡。
侧颅底转移瘤的诊断和治疗是一项跨学科挑战。CT和MRI扫描对于规划进一步治疗至关重要。对于出现头痛和脑神经麻痹的病例,在鉴别诊断中必须考虑侧颅底转移瘤。