Gulsen Salih, Terzi Aysen
Department of Neurosurgery, Baskent University Medical Faculty, Maresal Fevzi Cakmak Cad. 10. Sokak No: 45 C 06490, Bahcelievler, Ankara, Turkey.
Surg Neurol Int. 2013 Aug 28;4:111. doi: 10.4103/2152-7806.117176. eCollection 2013.
Uterine papillary serous adenocarcinoma (UPSAC) occurs 10-fold less frequently than endometrial carcinoma, and is referred to type 2 endometrial adenocarcinoma. The prognosis of UPSAC is worse than that of type I endometrial carcinoma. Herein we report what is only the second case of UPSAC, but it should prove to be more informative than the first reported case.
A 71-year-old female had three different metastases in the brain; two of the metastases were located in the posterior fossa within the cerebellar parenchyma with perilesional edema, but no mass effect, and the third metastasis was located in the right frontal lobe, and caused hemispheric edema and subfalcine herniation. The lesion that caused mass effect was completely extirpated without any surgical complications. The patient's recovery was excellent. She is able to walk independently, and use her left hand and left arm. Her Karnofsky performance score 5 months postsurgery was 80/100.
Based on the outcome in the presented case, we think that in any UPSAC patient with a metastatic brain tumor causing mass effect the symptomatic metastatic tumor must be removed, regardless of disease grade, to ensure optimal quality of life.
子宫浆液性乳头状腺癌（UPSAC）的发病率比子宫内膜癌低10倍，被称为2型子宫内膜腺癌。UPSAC的预后比I型子宫内膜癌更差。在此，我们报告的仅为UPSAC的第二例病例，但应比首例报告病例更具参考价值。
一名71岁女性脑部有三处不同的转移灶；其中两处转移灶位于小脑实质内的后颅窝，伴有病灶周围水肿，但无占位效应，第三处转移灶位于右额叶，引起半球水肿和大脑镰下疝。造成占位效应的病灶被完全切除，无任何手术并发症。患者恢复良好。她能够独立行走，使用左手和左臂。术后5个月她的卡氏功能状态评分是80/100。
基于本病例的结果，我们认为，对于任何患有引起占位效应的脑转移瘤的UPSAC患者，无论疾病分级如何，都必须切除有症状的转移瘤，以确保最佳生活质量。
