Flanagan Margaret E, Williams John R, Emerson Samuel N, Chiarelli Peter A, Ellenbogen Richard G, Cimino Patrick J
Department of Pathology, Division of Neuropathology, University of Washington, Seattle, WA, USA.
Department of Neurosurgery, University of Washington, Seattle, WA, USA.
Exp Mol Pathol. 2017 Apr;102(2):247-250. doi: 10.1016/j.yexmp.2017.02.011. Epub 2017 Feb 16.
Metastasis to the pineal region is a rare event, and esophageal adenocarcinoma metastatic to the pineal region is exceptionally rare, with only two cases reported in the current literature. Here, we characterize a third case of metastatic esophageal adenocarcinoma to the pineal region, and compare clinicopathological characteristics among all three cases. The three patients were men, with ages at neurological presentation ranging from 48 to 65years. Time from initial esophageal adenocarcinoma diagnosis to development of neurologic symptoms ranged from 12 to 23months. Neuroimaging in all cases showed an isolated enhancing pineal region mass with sizes ranging from 1.8 to 2.2cm. All cases were believed to have local control of esophageal disease prior to metastatic sequela, with initial treatment including esophageal resection with or without chemoradiation therapy. No cases had evidence of primary site disease progression at time of metastatic presentation, nor were there signs of other sites of metastasis. All patients underwent tumor excision and were referred for subsequent radiotherapy. Overall, all three cases demonstrate similar demographics, histology, and clinical presentations. In the appropriate clinical setting it is important to keep esophageal metastasis in the differential diagnosis, particularly in the setting of isolated pineal lesions.
转移至松果体区域是一种罕见情况，而食管腺癌转移至松果体区域则极为罕见，目前文献中仅报道过两例。在此，我们描述第三例转移至松果体区域的食管腺癌病例，并比较所有三例病例的临床病理特征。这三名患者均为男性，出现神经症状时的年龄在48岁至65岁之间。从最初诊断食管腺癌到出现神经症状的时间为12至23个月。所有病例的神经影像学检查均显示松果体区域有一个孤立的强化肿块，大小在1.8厘米至2.2厘米之间。所有病例在出现转移后遗症之前均被认为食管疾病已得到局部控制，初始治疗包括食管切除，伴或不伴放化疗。在出现转移时，所有病例均无原发部位疾病进展的证据，也没有其他转移部位的迹象。所有患者均接受了肿瘤切除，并接受了后续放疗。总体而言，所有三例病例在人口统计学、组织学和临床表现方面均相似。在适当的临床情况下，在鉴别诊断中考虑食管转移很重要，尤其是在出现孤立性松果体病变的情况下。
