Marciani M G, Stefani N, Peroni L, Stefanini F, Tarantino U, Gigli G L, Floris R
Dipartimento di Sanità Pubblica, II Università di Roma, Italia.
Acta Neurol Belg. 1990;90(3):149-56.
The evidence of CNS involvement in Ewing's sarcoma is uncommon and very often due to a direct extension of the tumor to extradural space and meninges. We report a case of a 14-year old girl with a primary ischio-pubic localization of Ewing's sarcoma. Body CT scan showed a bone lesion involving the left fronto-temporal region of the skull without affecting the brain. After chemotherapy radiological findings showed complete recovery. Ten months after treatment, the patient had neurological symptoms. Cerebral CT scan evidenced a large tumor mass localized in the right temporal lobe. Following radiotherapy the tumor mass was no longer visible. This case shows that late intraparenchymal CNS metastasis occurs independently from the previous skull lesion. Therefore these data, even through based on a single observation, lead to believe that in some cases prophylactic chemotherapy and radiotherapy of CNS may not be necessary.
中枢神经系统受累于尤因肉瘤的证据并不常见，且常常是由于肿瘤直接蔓延至硬膜外间隙和脑膜。我们报告一例14岁女孩，其原发性尤因肉瘤位于坐骨耻骨部位。全身CT扫描显示一处骨病变累及颅骨左额颞区域，但未影响大脑。化疗后影像学检查结果显示完全恢复。治疗十个月后，患者出现神经症状。脑部CT扫描证实右颞叶有一个大的肿瘤块。放疗后肿瘤块不再可见。该病例表明，晚期脑实质内中枢神经系统转移独立于先前的颅骨病变发生。因此，这些数据即使基于单一观察结果，也让人相信在某些情况下可能无需对中枢神经系统进行预防性化疗和放疗。
