Farooq Muhammad U, Chang Howard T
Department of Neurology and Ophthalmology, Michigan State University, East Lansing, MI 48824, USA.
Med Sci Monit. 2008 Sep;14(9):CS87-8.
Endometrial adenocarcinoma is one of the most common gynecological tumors in postmenopausal women. The distant metastasis mostly involves liver, lung and bone. Scalp metastases from endometrial adenocarcinoma are very rare.
A 63-year-old female with history of irregular vaginal bleeding presented with progressive headaches and a rapidly enlarging mass on the left forehead. There were no other associated symptoms including any motor or sensory deficits. MRI of the head showed a large 8 cm tumor extending from the left frontal subcutaneous tissue through the skull into the epidural space. CT scan of the abdomen, pelvis and thorax revealed a uterine mass and showed multiple signal abnormalities in the ribs and vertebra indicative of metastasis. The patient underwent craniotomy and also had an endometrial biopsy. Both craniotomy and endometrial biopsies revealed endometrioid adenocarcinoma.
This case illustrates that although scalp or intracranial metastases from endometrial adenocarcinoma are very rare, it must remain in the differential diagnosis in an elderly woman with dysfunctional uterine bleeding and a scalp tumor.
子宫内膜腺癌是绝经后女性最常见的妇科肿瘤之一。远处转移主要累及肝脏、肺和骨骼。子宫内膜腺癌头皮转移非常罕见。
一名63岁有不规则阴道出血病史的女性,出现进行性头痛,左前额有一迅速增大的肿块。无其他相关症状,包括任何运动或感觉障碍。头部MRI显示一个8厘米的大肿瘤,从左额皮下组织延伸穿过颅骨进入硬膜外间隙。腹部、骨盆和胸部CT扫描显示子宫有肿块,并在肋骨和椎骨上显示多个信号异常,提示转移。患者接受了开颅手术,并进行了子宫内膜活检。开颅手术和子宫内膜活检均显示为子宫内膜样腺癌。
本病例表明,虽然子宫内膜腺癌的头皮或颅内转移非常罕见,但对于有功能失调性子宫出血和头皮肿瘤的老年女性,仍必须将其列入鉴别诊断。