Division of Neurosurgery, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Japan.
Neurosurgery. 2010 Jun;66(6):E1213-4. doi: 10.1227/01.NEU.0000369193.03305.00.
Metastases to the choroid plexus from extracranial tumors are rare. Kidney, lung, and colon are the common primary origins of choroid plexus metastases. Choroid plexus metastases from thyroid carcinoma are very rare, with only 2 cases reported thus far. We report the third case of choroid plexus metastasis from thyroid carcinoma.
A 75-year-old man presented with severe headache, nausea, and vomiting. He had a history of thyroid carcinoma, which had metastasized to the lymph nodes and lung. Computed tomography, magnetic resonance imaging, and magnetic resonance angiography revealed right intraventricular hemorrhage with mild hydrocephalus, without evidence of a bleeding source. The bleeding source was assumed to be the choroid plexus metastasis in the trigone of the right lateral ventricle (following second admission).
Surgery was performed using a navigation-assisted system. The tumor was entirely removed, including some choroid plexus tissue. A ventriculoperitoneal shunt was also performed to treat the hydrocephalus. Histopathological examination revealed brain metastasis from papillary thyroid carcinoma. Postoperatively, the patient showed good recovery, with nausea and vomiting improved, and gait disturbance diminished. The patient was discharged from the hospital one month later.
Choroid plexus metastasis from papillary thyroid carcinoma is very rare, and this is the first case of intraventricular hemorrhage reported.
颅外肿瘤转移至脉络丛非常罕见。肾脏、肺部和结肠是脉络丛转移的常见原发部位。甲状腺癌转移至脉络丛更是极为罕见,目前仅报道了 2 例。我们报告第 3 例甲状腺癌脉络丛转移病例。
一名 75 岁男性因严重头痛、恶心和呕吐就诊。他曾患有甲状腺癌,已转移至淋巴结和肺部。计算机断层扫描、磁共振成像和磁共振血管造影显示右侧侧脑室三角区有脑出血伴轻度脑积水,但无明显出血来源。出血来源被认为是右侧侧脑室三角区(第二次入院时)的脉络丛转移瘤。
使用导航辅助系统进行手术。肿瘤被完全切除,包括一些脉络丛组织。还进行了脑室-腹腔分流术以治疗脑积水。组织病理学检查显示为甲状腺乳头状癌脑转移。术后,患者恢复良好,恶心和呕吐改善,步态障碍减轻。一个月后患者出院。
甲状腺乳头状癌脉络丛转移非常罕见,这是首例报道的脑室内出血病例。