Pougnet Isabelle, Murati Anne, Sarran Anthony, Viens Patrice, Sabatier Renaud
Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France.
Department of Pathology, Institut Paoli-Calmettes, Marseille, France ; Department of Radiology, Institut Paoli-Calmettes, Marseille, France ; Department of Molecular Oncology, INSERM U1068, Centre de Recherche en Cancérologie de Marseille, Marseille, France ; University of Aix-Marseille, Marseille, France.
Case Rep Oncol. 2014 Jan 16;7(1):33-8. doi: 10.1159/000358049. eCollection 2014 Jan.
Nervous central system metastases from head and neck squamous cell carcinoma (SCC) are rare. We report an exceptional case of isolated leptomeningeal and spinal cord involvement few years after the diagnosis of invasive SCC of the lip.
A 33-year-old man with a history of infracentimetric carcinoma of the lip developed back pain associated with progressive neurological disorders leading to paraplegia. This atypical presentation led to initial misdiagnosis, but radiological and cytological explorations finally confirmed the diagnosis of leptomeningeal and intramedullar secondary spinal cord lesions from his previously treated head and neck SCC. Systemic targeted therapy with epidermal growth factor receptor inhibitor and intrathecal chemotherapy led to prolonged disease stabilization.
To our knowledge, this is the first case of isolated neurological metastases from a head and neck SCC. Combination of systemic targeted therapy and intrathecal chemotherapy may be effective in such cases.
头颈部鳞状细胞癌（SCC）发生中枢神经系统转移较为罕见。我们报告了一例特殊病例，患者在唇部浸润性SCC诊断数年之后出现了孤立性软脑膜和脊髓受累。
一名33岁男性，有唇部微小癌病史，出现背痛并伴有进行性神经功能障碍，最终导致截瘫。这种非典型表现最初导致了误诊，但影像学和细胞学检查最终确诊为其先前治疗过的头颈部SCC所致的软脑膜和脊髓内继发性脊髓病变。使用表皮生长因子受体抑制剂进行全身靶向治疗和鞘内化疗使疾病得到了长期稳定。
据我们所知，这是首例头颈部SCC发生孤立性神经转移的病例。全身靶向治疗与鞘内化疗联合应用在这类病例中可能有效。
