Ko Jun Kyeung, Cha Seung Heon, Lee Jung Hwan, Choi Chang Hwa
Department of Neurosurgery, School of Medicine, Pusan National University, Busan, Korea.
J Korean Neurosurg Soc. 2012 Mar;51(3):141-3. doi: 10.3340/jkns.2012.51.3.141. Epub 2012 Mar 31.
The authors describe a case of choriocarcinoma that metastasized to the cerebral cortex, vertebral body, and intramedullary spinal cord. A 21-year-old woman presented with sudden headache, vomiting and a visual field defect. Brain computed tomography and magnetic resonance examinations revealed an intracranial hemorrhage in the left temporo-parietal lobe and two enhancing nodules in the left temporal and right frontal lobe. After several days, the size of the hemorrhage increased, and a new hemorrhage was identified in the right frontal lobe. The hematoma and enhancing mass in the left temporo-parietal lobe were surgically removed. Choriocarcinoma was diagnosed after histological examination. At 6 days after the operation, her consciousness had worsened and she was in a state of stupor. The size of the hematoma in the right frontal lobe was enlarged. We performed an emergency operation to remove the hematoma and enhancing mass. Her mental status recovered slowly. Two months thereafter, she complained of paraplegia with sensory loss below the nipples. Whole spine magnetic resonance imaging revealed a well-enhancing mass in the thoracic intramedullary spinal cord and L2 vertebral body. Despite chemotherapy and radiotherapy, the patient died 13 months after the diagnosis.
作者描述了一例绒毛膜癌转移至大脑皮质、椎体和脊髓髓内的病例。一名21岁女性出现突发头痛、呕吐和视野缺损。脑部计算机断层扫描和磁共振检查显示左颞顶叶颅内出血以及左颞叶和右额叶有两个强化结节。几天后，出血面积增大，右额叶发现新的出血。左颞顶叶的血肿和强化肿块通过手术切除。组织学检查后诊断为绒毛膜癌。术后6天，她的意识恶化，处于昏迷状态。右额叶血肿面积增大。我们进行了紧急手术以清除血肿和强化肿块。她的精神状态恢复缓慢。两个月后，她主诉双下肢瘫痪，乳头以下感觉丧失。全脊柱磁共振成像显示胸段脊髓髓内和L2椎体有一个强化明显的肿块。尽管进行了化疗和放疗，患者在诊断后13个月死亡。
