Kouitcheu R, Appay R, Diallo M, Troude L, Melot A
Department of neurosurgery, CHU-hôpital Nord, Marseille, France.
Department of pathology and neuropathology, CHU-Timone, Marseille, France.
Neurochirurgie. 2019 Feb;65(1):43-48. doi: 10.1016/j.neuchi.2018.09.004. Epub 2019 Jan 30.
Thymic epithelial tumors (TET) are rare lesions. The brain metastases of these tumors are even rarer. We report a case of brain metastases in a known patient with a thymic carcinoma diagnosed in October 2016. She was a 73-year-old woman who presented with headache, nausea, and right hemiplegia. Brain MRI revealed five lesions (1 insular, 1 frontal and 2 left temporal, 1 right parafalcine). These lesions were initially treated using two stereotactic radiosurgery gamma knives. A macroscopically complete excision of the left frontal lesion was subsequently performed without any complications with a good evolution of the neurological symptoms postoperatively. Immunohistochemical examination was compatible with metastatic thymic carcinoma. The patient died 14 months after the initial diagnosis. A review of the literature in English has reported another 45 TET cases with brain metastases.
胸腺上皮肿瘤（TET）是罕见的病变。这些肿瘤的脑转移更为罕见。我们报告一例已知的2016年10月诊断为胸腺癌患者发生脑转移的病例。患者为一名73岁女性，出现头痛、恶心和右侧偏瘫。脑部磁共振成像（MRI）显示有五个病灶（1个岛叶、1个额叶、2个左侧颞叶、1个右侧旁矢状窦旁）。这些病灶最初采用两台立体定向放射外科伽玛刀进行治疗。随后对左侧额叶病灶进行了肉眼下完整切除，未出现任何并发症，术后神经症状恢复良好。免疫组织化学检查结果符合转移性胸腺癌。患者在初次诊断后14个月死亡。对英文文献的回顾报告了另外45例发生脑转移的胸腺上皮肿瘤病例。
