Department of Neurosurgery, University Hospital of Ioannina, Greece.
Acta Neurol Belg. 2009 Dec;109(4):322-5.
Metastatic brain tumors are the most common intracranial neoplasm in adults. Bladder cancer gives metastasis to the brain in less than 1%. Herewith, we report on a case of a 71-year-old man who was admitted to the emergency department after an episode of loss of consciousness. On neurological examination a left hemiparesis was observed. The patient's previous history entailed a total cystectomy and radical prostatectomy 7 months ago because of a transitional cell carcinoma (TCC) of the urinary bladder. Brain imaging work-up revealed a cystic lesion with perifocal edema in the right frontal lobe. The patient was operated and the histological diagnosis was consistent with a metastatic carcinoma, with morphological, histochemical and immunohistochemical features comparable to those of the primary tumor. Postoperative the patient was in excellent neurological state and received complementary chemotherapy and total brain irradiation. Additional imaging and laboratory examinations excluded other metastatic lesion. The patient died 18 months later due to systemic disease. Although intracranial metastases from TCC of urinary bladder have a low incidence, in follow-up examinations any alterations in neurological status in these patients should be thoroughly evaluated.
脑转移瘤是成年人中最常见的颅内肿瘤。膀胱癌脑转移的发生率低于 1%。在此，我们报告 1 例 71 岁男性患者，在意识丧失发作后被收入急诊科。神经系统检查发现左侧偏瘫。患者既往有膀胱癌病史，7 个月前因移行细胞癌（TCC）行全膀胱切除术和根治性前列腺切除术。脑部影像学检查显示右额叶有囊性病变伴周围水肿。患者接受了手术，组织学诊断为转移性癌，形态学、组织化学和免疫组织化学特征与原发性肿瘤相似。术后患者神经状态良好，接受了补充化疗和全脑放疗。进一步的影像学和实验室检查排除了其他转移病灶。18 个月后，患者死于全身疾病。尽管膀胱癌脑转移的发生率较低，但在这些患者的随访检查中，任何神经状态的改变都应进行彻底评估。
