Okada Eijiro, Nakamura Masaya, Koshida Yoshitomo, Mukai Kiyoshi, Toyama Yoshiaki, Matsumoto Morio
J Spinal Cord Med. 2015 Mar;38(2):231-5. doi: 10.1179/2045772314Y.0000000201. Epub 2014 Mar 12.
Systemic metastasis to a primary tumor of the central nervous system is uncommon. Breast carcinomas metastasizing to a possibly preexisting meningioma in the spine are reported very rarely.
Case report.
A 69-year-old female was referred to us with progressive gait disturbance. She had undergone a total mastectomy for carcinoma of the right breast 11 years previously. A magnetic resonance imaging of the thoracic spine showed an intra- and extradural spinal cord tumor. The patient underwent resection of the tumor via laminectomy from T2 to T4. After the operation, the patient's neurological status improved significantly, and she was able to walk without assistance. Histological examination showed the tumor to be a fibrous-type meningioma within a metastatic breast cancer tumor. The patient underwent 40 Gy radiation treatment for local control of the tumor. However, the tumor recurred locally 7 months after the surgery. The patient died of carcinomatous pleurisy 13 months after the surgery.
This case illustrates that a primary meningioma in the thoracic spine can be a recipient of breast cancer metastasis, which may alter the treatment strategy.
中枢神经系统原发性肿瘤发生全身转移并不常见。乳腺癌转移至脊柱可能已存在的脑膜瘤的报道极为罕见。
病例报告。
一名69岁女性因进行性步态障碍前来就诊。她11年前因右乳癌接受了全乳切除术。胸椎磁共振成像显示硬膜内和硬膜外脊髓肿瘤。患者通过T2至T4椎板切除术切除肿瘤。术后，患者神经状态明显改善，能够独立行走。组织学检查显示肿瘤为转移性乳腺癌肿瘤内的纤维型脑膜瘤。患者接受了40 Gy放射治疗以局部控制肿瘤。然而，术后7个月肿瘤局部复发。患者术后13个月死于癌性胸膜炎。
该病例表明胸椎原发性脑膜瘤可能是乳腺癌转移的受体，这可能会改变治疗策略。
