Kon Tomoya, Funamizu Yukihisa, Miki Yasuo, Tomiyama Masahiko, Baba Masayuki, Kurotaki Hidekachi, Wakabayashi Koichi
Department of Neuropathology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; Department of Neurology, Aomori Prefectural Central Hospital, Aomori, Japan.
Neuropathology. 2014 Oct;34(5):499-503. doi: 10.1111/neup.12127. Epub 2014 Apr 30.
Meningeal carcinomatosis is a well-known complication of malignant neoplasms. We report a case of meningeal carcinomatosis of 2 months' duration in a 22-year-old man, in whom the initial symptom was gradually worsening headache. Postmortem examination revealed infiltrating adenocarcinoma of the stomach. Carcinoma cells showed diffuse spread to the subarachnoid space of the brain and spinal cord. In many places, subarachnoid tumor cells had infiltrated to the cranial and spinal nerves. Moreover, carcinoma cells in the nerve roots extended to the parenchyma of the brain and spinal cord beyond the CNS-peripheral nervous system junction. These findings suggest that cranial and spinal nerve roots can be a possible route of parenchymal invasion in meningeal carcinomatosis.
脑膜癌病是恶性肿瘤的一种众所周知的并发症。我们报告一例22岁男性患者,病程2个月的脑膜癌病,其最初症状为逐渐加重的头痛。尸检显示胃浸润性腺癌。癌细胞弥漫性扩散至脑和脊髓的蛛网膜下腔。在许多部位,蛛网膜下腔肿瘤细胞已浸润至颅神经和脊神经。此外,神经根中的癌细胞延伸至中枢神经系统 - 周围神经系统交界处以外的脑和脊髓实质。这些发现表明,颅神经和脊神经根可能是脑膜癌病中实质浸润的一条可能途径。