Campos Paiva Aline Lariessy, Vitorino Araujo João Luiz, Ferraz Vinícius Ricieri, Esteves Veiga José Carlos
MD. Neurosurgery Resident, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), São Paulo (SP), Brazil.
PhD. Assistant Neurosurgeon, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), and Neurosurgeon, Instituto do Câncer Arnaldo Vieira de Carvalho (ICAVC), Oncocenter and Hospital Nove de Julho, São Paulo (SP), Brazil.
Sao Paulo Med J. 2017 May-Jun;135(3):296-301. doi: 10.1590/1516-3180.2016.016228102016. Epub 2017 May 29.
: Brain metastases are the most common tumors of the central nervous system. Because of their high frequency, they may be associated with rare situations. Among these are tumor-to-tumor metastasis and an even a rarer situation called simultaneous brain tumors, which are more related to primary tumors of the reproductive and endocrine systems.
: A 56-year-old male patient with a history of renal cell carcinoma (which had previously been resected) presented with a ventricular lesion (suggestive of metastatic origin) and simultaneous olfactory groove lesion (probably a meningioma). First, only the ventricular lesion was dealt with, but after a year, the meningothelial lesion increased and an occipital lesion appeared. Therefore, both of these were resected in a single operation. All the procedures were performed by the same neurosurgeon. The patient evolved without neurological deficits during the postoperative period. After these two interventions, the patient remained well and was referred for adjuvant treatment.
: This study provides the first description of an association between these two tumors. Brain metastases may be associated with several lesions, and rare presentations such as simultaneity with meningioma should alert neurosurgeons to provide the best oncological treatment.
脑转移瘤是中枢神经系统最常见的肿瘤。由于其高发性,可能会伴有罕见情况。其中包括肿瘤-to-肿瘤转移,甚至一种更罕见的情况称为同时性脑肿瘤,这与生殖和内分泌系统的原发性肿瘤关系更为密切。
一名56岁男性患者,有肾细胞癌病史(此前已切除),出现一个脑室病变(提示转移瘤起源)和同时出现的嗅沟病变(可能是脑膜瘤)。首先,仅处理了脑室病变,但一年后,脑膜内皮病变增大且出现了枕部病变。因此,在一次手术中对这两个病变都进行了切除。所有手术均由同一位神经外科医生进行。术后患者病情进展未出现神经功能缺损。经过这两次干预后,患者情况良好并被转诊接受辅助治疗。
本研究首次描述了这两种肿瘤之间的关联。脑转移瘤可能与多种病变相关,像与脑膜瘤同时出现这样的罕见表现应提醒神经外科医生提供最佳的肿瘤治疗方案。