Kuan-Yin Tseng, Dueng-Yuan Hueng, Hsin-I Ma
Tri-Service General Hospital, Department of Neurological Surgery, Taipei City, Thaiwan, Province of China.
Turk Neurosurg. 2013;23(6):796-9. doi: 10.5137/1019-5149.JTN.3696-10.3.
Skull bone metastasis from the gastric cancer is a rare. We reported a 52-year-old male proven to have stomach cancer and who underwent subtotal gastrectomy 5 months previously. Within the past 2 weeks, he experienced headache and dizziness followed by weakness of the left lower limb. A diagnosis of right chronic subdural hematoma (SDH) was made, and a burr hole was performed for drainage of the hematoma. However, 5 days later, the patient had sudden loss of consciousness without external evidence of trauma to the head. An emergency computed tomography (CT) scan revealed a high-density lesion consistent with an acute SDH on the right side. Histologically, metastasis of gastric adenocarcinoma was detected in both the dura mater and skull. It is suggested that the SDH was caused by the rupture of vessels in the metastasis or rupture of the inner dural vessels, possibly resulting from congestion of the outer vessels.
胃癌颅骨转移较为罕见。我们报告了一名52岁男性,此前已确诊患有胃癌,并于5个月前接受了胃次全切除术。在过去2周内,他出现头痛、头晕,随后左下肢无力。诊断为右慢性硬膜下血肿(SDH),并进行了钻孔引流血肿。然而,5天后,患者突然意识丧失,头部无外伤的外部证据。急诊计算机断层扫描(CT)显示右侧有一个与急性SDH相符的高密度病变。组织学检查发现硬脑膜和颅骨均有胃腺癌转移。提示SDH是由转移灶内血管破裂或硬脑膜内血管破裂引起的,可能是由于外层血管充血所致。