Barbiero Frank J, Huttner Anita J, Judson Benjamin L, Baehring Joachim M
Department of Neurology, Yale School of Medicine, New Haven, CT 06510, USA.
Department of Pathology, Yale School of Medicine, New Haven, CT 06520, USA.
CNS Oncol. 2017 Oct;6(4):281-285. doi: 10.2217/cns-2017-0004. Epub 2017 Oct 9.
Leiomyosarcomas are malignant tumors displaying strong smooth muscle differentiation. They can often develop within the GI tract and myometrium, but are particularly rare in the head and neck. Perineurial spread of head and neck cancer is observed in patients with neoplasms of the skin (squamous cell carcinoma, melanoma) or skin appendages (adenoid cystic carcinoma). We report the case of a woman who presented with diplopia and headaches. MRI showed an infratemporal mass lesion and faint enhancement tracking along the mandibular nerve into the wall of the right cavernous sinus. A nerve biopsy revealed leiomyosarcoma. We review the medical literature to provide further insight into the diagnosis and management of this tumor and its peculiar pattern of spread. A similar case was unidentifiable in the literature.
平滑肌肉瘤是表现出强烈平滑肌分化的恶性肿瘤。它们常发生于胃肠道和子宫肌层，但在头颈部尤为罕见。头颈部癌的神经周扩散见于皮肤肿瘤（鳞状细胞癌、黑色素瘤）或皮肤附属器肿瘤（腺样囊性癌）患者。我们报告一例出现复视和头痛的女性病例。磁共振成像显示颞下有肿块病变，并有沿下颌神经进入右侧海绵窦壁的轻微强化。神经活检显示为平滑肌肉瘤。我们回顾医学文献以进一步深入了解该肿瘤的诊断和治疗及其独特的扩散模式。文献中未发现类似病例。
