Aiyer Rohit, Engelman Ester, Xue Wei, Yu Edward
Department of Psychiatry, Hofstra Northwell Health-Staten Island University Hospital, Staten Island, New York, USA.
Department of Radiology, Harlem Hospital Center, New York, New York, USA.
BMJ Case Rep. 2016 Apr 12;2016:bcr2016214666. doi: 10.1136/bcr-2016-214666.
A 61-year-old woman presented to the emergency department, with a 4-day history of isolated oropharyngeal dysphagia associated with anorexia and weight loss over the previous 4 weeks. She had no other focal neurological symptoms and no deficits on examination. She had been in a 4-year remission of breast cancer postmastectomy and chemoradiation. Neuroimaging showed enhancement of cranial nerves VII, VIII, cisternal segment of cranial V, dorsal and ventral surfaces of the cervical and thoracic cord as well as enhancement of the cauda equina. Cerebrospinal fluid analysis revealed carcinomatous cells. The patient was diagnosed as having leptomeningeal carcinomatosis secondary to lobular breast cancer and was started on radiation therapy, antihormonal treatments and intrathecal methotrexate.
一名61岁女性因孤立性口咽吞咽困难4天就诊于急诊科，在过去4周内伴有厌食和体重减轻。她没有其他局灶性神经症状，检查也无异常。她在乳腺癌乳房切除术后及放化疗后已缓解4年。神经影像学显示颅神经VII、VIII、颅神经V脑池段、颈髓和胸髓背侧及腹侧表面强化，以及马尾强化。脑脊液分析发现癌细胞。该患者被诊断为小叶性乳腺癌继发软脑膜癌病，并开始接受放射治疗、抗激素治疗及鞘内注射甲氨蝶呤。
