Piura Ettie, Piura Benjamin
Department of Obstetrics and Gynecology, Sapir Medical Center, Sackler School of Medicine, University of Tel-Aviv, Kfar Saba 44281, Israel.
ISRN Oncol. 2012;2012:581749. doi: 10.5402/2012/581749. Epub 2012 Mar 18.
This paper will focus on knowledge related to brain metastases from endometrial carcinoma. To date, 115 cases were documented in the literature with an incidence of 0.6% among endometrial carcinoma patients. The endometrial carcinoma was usually an advanced-stage and high-grade tumor. In most patients (90%), brain metastasis was detected after diagnosis of endometrial carcinoma with a median interval from diagnosis of endometrial carcinoma to diagnosis of brain metastases of 17 months. Brain metastasis from endometrial carcinoma was either an isolated disease limited to the brain only (50%) or part of a disseminated disease involving also other parts of the body (50%). Most often, brain metastasis from endometrial carcinoma affected the cerebrum (75%) and was solitary (~60%). The median survival after diagnosis of brain metastases from endometrial carcinoma was 5 months; however, a significantly better survival was achieved with multimodal therapy including surgical resection or stereotactic radiosurgery followed by whole brain radiotherapy (WBRT) and/or chemotherapy compared to WBRT alone. It is suggested that brain imaging studies should be considered in the routine follow up of patients with endometrial carcinoma and that the search for a primary source in females with brain metastases of unknown primary should include endometrial biopsy.
本文将聚焦于子宫内膜癌脑转移的相关知识。迄今为止,文献记载了115例病例,在子宫内膜癌患者中的发生率为0.6%。子宫内膜癌通常是晚期高级别肿瘤。在大多数患者(约90%)中,脑转移在子宫内膜癌诊断后被发现,从子宫内膜癌诊断到脑转移诊断的中位间隔时间为17个月。子宫内膜癌脑转移要么是仅局限于脑部的孤立性疾病(约50%),要么是累及身体其他部位的播散性疾病的一部分(约50%)。最常见的是,子宫内膜癌脑转移累及大脑(约75%)且为单发(约60%)。子宫内膜癌脑转移诊断后的中位生存期为5个月;然而,与单纯全脑放疗相比,包括手术切除或立体定向放射外科手术,随后进行全脑放疗(WBRT)和/或化疗的多模式治疗可显著提高生存率。建议在子宫内膜癌患者的常规随访中考虑进行脑成像检查,并且在原发灶不明的脑转移女性患者中寻找原发灶应包括子宫内膜活检。