Yang Jen-Tsung, Chang Chia-Mao, Lee Ming-Hsueh, Chen Yu-Jung, Lee Kam-Fai
Department of Neurosurgery, Chang Gung Memorial Hospital, Chia-Yi, and College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
Acta Neurol Taiwan. 2010 Mar;19(1):41-4.
Thymic carcinomas are rare epithelial malignancies with marked invasive tendency which can metastasize to distant organs, most commonly to the lung, bone, liver, kidney and extra-thoracic lymph nodes. Central nervous system metastasis is extremely rare and only 45 such cases have been reported in the English literature. We reported a 42-year-old male with thymic squamous cell carcinoma and lung and bones metastases. He underwent thymomectomy and pulmonary lobectomy with concurrent chemo-radiotherapy. Based on the clinical symptoms of severe headache and vomiting and the results of brain computed tomography and magnetic resonance imaging scans, 2 metastatic tumors with a cystic component were diagnosed. We resected the metastatic tumors and the signs of increased intracranial pressure subsided immediately after the operation. The patient underwent continuous chemotherapy systemically and whole brain irradiation for disease control. This presentation suggests that surgical resection with concurrent chemo-radiotherapy is the treatment of choice for thymic carcinomas with brain metastases.
胸腺癌是一种罕见的上皮性恶性肿瘤，具有明显的侵袭倾向，可转移至远处器官，最常见的是肺、骨、肝、肾和胸外淋巴结。中枢神经系统转移极为罕见，英文文献中仅报道了45例此类病例。我们报告了一名42岁男性，患有胸腺鳞状细胞癌并伴有肺和骨转移。他接受了胸腺切除术和肺叶切除术，并同时进行了放化疗。基于严重头痛和呕吐的临床症状以及脑部计算机断层扫描和磁共振成像扫描结果，诊断出2个伴有囊性成分的转移瘤。我们切除了转移瘤，术后颅内压升高的症状立即缓解。患者接受了全身持续化疗和全脑照射以控制病情。本病例提示，手术切除并同时进行放化疗是治疗伴有脑转移的胸腺癌的首选方法。
