Tamatani S, Tanimura K, Kawamata M, Kurashima A, Furuta A, Ikuta F
Department of Neurosurgery, Sannocho Hospital, Niigata, Japan.
No Shinkei Geka. 1991 Jul;19(7):649-53.
We report here a specific case of metastatic brain tumor orienting from rhabdomyosarcoma. An 11-year-old boy came to our hospital with complaints including headache, exophthalmos and tumors in the right frontal and left occipital region. 6 months previously subtotal removal of rhabdomyosarcoma in his right foot had been performed. CT scan demonstrated tumors in the right orbit, right frontal region and left occipital region. The tumors existed bilaterally in the skull and markedly enhanced by contrast medium. But the changes of the cranium were mild, only the dipole was slightly dilated. MRI showed that the tumors were extraaxial masses. Right external carotid angiogram revealed numerous tumor vessels fed by the meningeal artery. On April 3rd, biopsy was performed at the right frontal region. The tumor had spread in the epidural space but the cortical surface seemed to be intact. Histologically, the tumor consisted of small round cells and revealed multinuclear giant cells. It involved the skull bone, dura mater and subdural tissues. Accordingly the tumor was diagnosed as rhabdomyosarcoma. Although tumor increased rapidly, the intracranial region did not change remarkably. It was an interesting phenomenon. Eventually, rhabdomyosarcoma metastasized to the lung, and the patient died due to respiratory distress.
我们在此报告一例源自横纹肌肉瘤的转移性脑肿瘤的特殊病例。一名11岁男孩因头痛、眼球突出以及右额部和左枕部肿物前来我院就诊。6个月前，其右脚的横纹肌肉瘤已行次全切除。CT扫描显示右眼眶、右额部和左枕部有肿物。肿物双侧存在于颅骨内，造影剂增强明显。但颅骨改变轻微，仅双侧脑室轻度扩张。MRI显示肿物为轴外肿块。右侧颈外动脉血管造影显示有许多由脑膜动脉供血的肿瘤血管。4月3日，在右额部进行了活检。肿瘤已扩散至硬膜外间隙，但皮质表面似乎完整。组织学检查显示，肿瘤由小圆细胞组成，并可见多核巨细胞。肿瘤累及颅骨、硬脑膜和硬膜下组织。因此，该肿瘤被诊断为横纹肌肉瘤。尽管肿瘤迅速增大，但颅内区域变化并不明显。这是一个有趣的现象。最终，横纹肌肉瘤转移至肺部，患者因呼吸窘迫死亡。
