Fernandes R
Department of Neurology, Kingston Hospital, Surrey, UK.
BMJ Case Rep. 2010 Aug 24;2010:bcr0520102998. doi: 10.1136/bcr.05.2010.2998.
The authors present the case of a middle-aged woman diagnosed with lobar carcinoma in situ in her right breast. She eventually underwent a mastectomy and reconstruction. Histology revealed grade II invasive ductal carcinoma and she was commenced on adjuvant letrozole. The following year a MRI scan revealed she had developed spinal metastases and CT confirmed the presence of liver and lung metastases. She presented with a 5-month history of tongue weakness and difficulty manipulating food to the back of her mouth. On examination, there was marked right-sided hemiatrophy of the tongue with deviation of the tongue to the right side upon protrusion. MRI demonstrated ill-defined enhancing material close to the intracranial opening of the right hypoglossal canal. The patient was referred for consideration of radiotherapy. Due to the comorbidities of the patient, she was not a candidate for neurosurgical intervention.
作者报告了一例中年女性病例，该患者被诊断为右乳原位叶癌。她最终接受了乳房切除术和重建手术。组织学检查显示为II级浸润性导管癌，并开始使用来曲唑进行辅助治疗。次年，磁共振成像（MRI）扫描显示她出现了脊柱转移，计算机断层扫描（CT）证实存在肝转移和肺转移。她有5个月的舌肌无力病史，且难以将食物送到口腔后部。检查发现，舌头右侧明显萎缩，伸出时舌尖偏向右侧。MRI显示在右舌下神经管颅内开口附近有边界不清的强化物质。该患者被转诊以考虑进行放射治疗。由于患者存在多种合并症，她不适合接受神经外科干预。
