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乳腺癌颅内脑膜瘤转移。

Breast carcinoma metastasis to intracranial meningioma.

机构信息

Department of Pathology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.

出版信息

J Clin Neurosci. 2009 Dec;16(12):1636-9. doi: 10.1016/j.jocn.2009.02.020. Epub 2009 Sep 17.

Abstract

Meningiomas and breast cancers are common tumors among women in the fifth to seventh decade. However, metastasis from breast cancer to an intracranial meningioma is rare. A 63-year-old woman presented with headache, nausea and vomiting, and progressive right hemiparesis for one month. She had undergone a right modified radical mastectomy in another hospital 10 years prior. At that time, the pathological diagnosis was infiltrating ductal carcinoma. She required adjuvant radiotherapy and chemotherapy for a local recurrence 7 years later. On admission to our hospital, cranial CT scans showed a brightly enhancing, irregularly shaped lesion over the left high parietal lobe with surrounding parenchymal edema. Histopathological examination of the lesion revealed two distinct tumor types, meningioma and metastatic carcinoma of breast tissue origin. Although meningiomas have well-known radiological features, other tumors, including metastases from breast cancers may simulate them. In the clinical setting of previously diagnosed breast cancer, prompt craniotomy for removal of meningioma-like intracranial lesions is recommended to avoid missing the diagnosis of breast cancer metastasis which carries a poorer prognosis than meningioma and requires a different treatment strategy.

摘要

脑膜瘤和乳腺癌是女性在第五至第七个十年中常见的肿瘤。然而,乳腺癌转移至颅内脑膜瘤则较为罕见。一位 63 岁女性因头痛、恶心和呕吐以及右侧偏瘫进行性加重 1 个月而就诊。10 年前她在另一家医院接受了右侧改良根治性乳房切除术。当时,病理诊断为浸润性导管癌。7 年后因局部复发接受了辅助放疗和化疗。入院时,颅脑 CT 扫描显示左顶叶高区有一个强化明显、形状不规则的病变,伴有周围实质水肿。病变的组织病理学检查显示出两种截然不同的肿瘤类型,脑膜瘤和来源于乳腺组织的转移性癌。尽管脑膜瘤具有众所周知的影像学特征,但其他肿瘤,包括乳腺癌的转移瘤,也可能与之类似。在先前诊断为乳腺癌的临床情况下,建议对脑膜瘤样颅内病变进行及时的开颅手术切除,以避免漏诊乳腺癌转移,后者的预后比脑膜瘤差,需要不同的治疗策略。

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