Department of Neurosurgery, University Hospital Coventry and Warwickshire NHS Trust, Walsgrave, Coventry, CV2 2DX, UK.
J Clin Neurosci. 2010 Feb;17(2):265-7. doi: 10.1016/j.jocn.2009.05.029. Epub 2009 Dec 29.
We report a 37-year-old man with a primary intracranial oligodendroglioma presenting later with symptomatic multiple cerebrospinal fluid (CSF) intradural drop spinal metastases. This patient initially presented in 2006 with complex partial seizures. Initial histology demonstrated World Health Organization (WHO) grade 2 oligodendroglioma. The patient had further generalised seizures 7 months after initial tumour resection. MRI at that time confirmed tumour recurrence. The patient underwent a repeat craniotomy. Histology showed anaplastic transformation to a WHO grade 3 oligodendroglioma. About 30 months after his initial presentation, the patient developed a focal neurological deficit in the left leg with associated retention of urine. MRI of the neuraxis demonstrated widespread leptomeningeal metastatic drop deposits within the spinal canal. We discuss the mechanisms involved in tumour dissemination throughout the CSF. We also review the relevant literature regarding this phenomenon.
我们报告了一例 37 岁的原发性颅内少突胶质细胞瘤患者，随后出现症状性多发性脑脊膜（CSF）硬膜内滴状脊髓转移。该患者最初于 2006 年出现复杂部分性癫痫发作。初始组织学表现为世界卫生组织（WHO）2 级少突胶质细胞瘤。初次肿瘤切除后 7 个月，患者再次出现全身性癫痫发作。当时的 MRI 证实肿瘤复发。患者接受了再次开颅手术。组织学显示为 WHO 3 级间变性少突胶质细胞瘤。初次就诊后约 30 个月，患者出现左腿局灶性神经功能缺损，伴有尿潴留。中枢神经系统 MRI 显示椎管内广泛的软脑膜转移性滴状沉积。我们讨论了肿瘤在整个 CSF 中扩散的相关机制。我们还回顾了关于这种现象的相关文献。
