Shin Tae-Hee, Jung Young-Jin, Kim Oh-Lyong, Kim Min-Su
Department of Neurosurgery, Yeungnam University College of Medicine, Daegu, Korea.
J Korean Neurosurg Soc. 2012 Jul;52(1):55-7. doi: 10.3340/jkns.2012.52.1.55. Epub 2012 Jul 31.
Alveolar soft part sarcoma (ASPS) with skull and brain metastases is extremely rare. A 53-year-old patient diagnosed as skull metastasis of ASPS visited our clinic complaining of an outgrowing scalp mass in spite of radiation therapy. Past medical history revealed that the patient had been diagnosed and treated for ASPS of the thigh 4 years ago. Magnetic resonance imaging revealed a hyperintense ovoid mass on the T2-weighted image, an isointense on the T1-weighted image, and a homogeneous enhanced mass with gadolinium. Another small-sized enhanced mass with mild peritumoral swelling was found at the deep white matter of the left frontal lobe. A gross total resection of the skull lesion with cranioplasty was performed for the surgical defect. A histologic examination of the specimens revealed metastatic ASPS involving the skull. Surgery with a total removal of the lesions may be effective for improving a patient's symptoms especially from neurological dysfunction.
伴有颅骨和脑转移的肺泡软组织肉瘤（ASPS）极为罕见。一名53岁被诊断为ASPS颅骨转移的患者前来我院就诊，主诉尽管接受了放射治疗，但头皮肿物仍在生长。既往病史显示，该患者4年前曾被诊断并接受过大腿ASPS的治疗。磁共振成像显示，T2加权图像上有一个高强度椭圆形肿物，T1加权图像上呈等强度，钆增强后肿物均匀强化。在左侧额叶深部白质发现另一个小的强化肿物，伴有轻度瘤周肿胀。对颅骨病变进行了颅骨成形术的全切除手术以修复手术缺损。标本的组织学检查显示转移的ASPS累及颅骨。彻底切除病变的手术可能对改善患者症状有效，尤其是对神经功能障碍。
