Fujimoto Kenji, Kuroda Jun-ichiro, Makino Keishi, Hasegawa Yu, Kuratsu Jun-ichi
Department of Neurosurgery, Faculty of Life Sciences, Kumamoto University School of Medicine.
Neurol Med Chir (Tokyo). 2013;53(10):717-21. doi: 10.2176/nmc.cr2012-0237. Epub 2013 Sep 27.
Skull metastases occur in patients with various malignancies; however, those resulting from intrahepatic cholangiocarcinoma (ICC) have been rarely reported. In our hospital, 324 patients were diagnosed with metastatic brain or skull tumors from June 1969 to June 2011, but only 3 of them (0.9%) developed skull metastases from ICC. We report the case of 3 patients with skull metastases from ICC. A combination of computed tomography (CT), contrast-enhanced magnetic resonance imaging (MRI), 18F-fluorodeoxyglucose positron emission tomography (FDG-PET), and methionine-PET were used for imaging. Sites of tumors were the lateral left orbit and right parietal bone in case 1, the left parietal bone, left temporal bone, and lateral left orbit in case 2, the right petrous bone, right occipital bone, and upper cervical vertebra in case 3. The metastases were confirmed to have originated from ICC by biopsy in two of the cases and diagnosed by MRI and FDG-PET in case 2. Radiosurgery and radiotherapy had positive effects on symptom improvement and cosmetic problems.
颅骨转移发生于患有各种恶性肿瘤的患者中；然而，由肝内胆管癌（ICC）导致的颅骨转移很少被报道。在我院，1969年6月至2011年6月期间，有324例患者被诊断为脑或颅骨转移性肿瘤，但其中只有3例（0.9%）发生了来自ICC的颅骨转移。我们报告3例ICC颅骨转移患者的病例。使用计算机断层扫描（CT）、增强磁共振成像（MRI）、18F-氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）和蛋氨酸-PET进行联合成像。病例1的肿瘤部位是左侧眶外侧和右侧顶骨，病例2是左侧顶骨、左侧颞骨和左侧眶外侧，病例3是右侧岩骨、右侧枕骨和上颈椎。其中2例通过活检证实转移灶起源于ICC，病例2通过MRI和FDG-PET诊断。立体定向放射外科和放射治疗对症状改善和美容问题有积极作用。
