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[伴有颅神经麻痹的乳腺癌颅骨转移放疗指征]

[Indication for Radiotherapy for Breast Cancer Metastasis to the Skull Base Accompanied by Cranial Nerve Palsies].

作者信息

Azami Ayaka, Azami Yusuke, Ohtake Tohru, Tachibana Kazunoshin, Tomura Noriaki, Seto Ichiro, Todate Yukitoshi, Waragai Mitsuru, Suzuki Nobuyasu, Sato Atai, Takano Yoshinao, Abe Tsuyoshi, Teranishi Yasushi

机构信息

Dept. of Surgery, Southern Tohoku General Hospital.

出版信息

Gan To Kagaku Ryoho. 2018 Dec;45(13):1806-1808.

Abstract

Distant metastasis to the skull base region frequently manifests various cranial nerve symptoms and reduces patients' quality of life(QOL). We report a 62-year-old woman with skull base metastasis of breast cancer, whose condition clinically improved following palliative radiotherapy. The patient presented to our hospital with hoarseness. CT screening revealed a tumor in the right breast, axial lymph node swelling, and osteoblastic change at multiple sites. A core needle biopsy of the breast tumor revealed invasive lobular carcinoma. She also had nausea, anorexia, vertigo, lower left angle of the mouth, apraxia of lid closing, and dysphagia owing to several cranial nerve palsies. MRI T1- and T2-weighted images showed a diffuse low-signal intensity of the skull base region, and the patient was diagnosed as having breast cancer with symptomatic skull base metastases. Her cranial nerve symptoms improved after 1 week of palliative irradiation to the skull base. We conclude that, even among terminal-stage patients, palliative radiotherapy to the skull base region is an effective treatment option to improve patients' QOL.

摘要

远处转移至颅底区域常表现出各种颅神经症状,降低患者的生活质量(QOL)。我们报告了一名62岁患有乳腺癌颅底转移的女性患者,其病情在姑息性放疗后临床症状得到改善。该患者因声音嘶哑前来我院就诊。CT筛查发现右乳有肿瘤、腋窝淋巴结肿大以及多个部位的成骨改变。乳腺肿瘤的粗针活检显示为浸润性小叶癌。由于多处颅神经麻痹,她还出现恶心、厌食、眩晕、左侧口角下垂、闭眼失用和吞咽困难。MRI T1加权和T2加权图像显示颅底区域弥漫性低信号强度,患者被诊断为患有伴有症状性颅底转移的乳腺癌。对颅底进行1周的姑息性放疗后,她的颅神经症状有所改善。我们得出结论,即使在晚期患者中,对颅底区域进行姑息性放疗也是改善患者生活质量的有效治疗选择。

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