Department of Neurosurgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea.
Department of Neurosurgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea.
World Neurosurg. 2019 Jun;126:160-163. doi: 10.1016/j.wneu.2019.03.029. Epub 2019 Mar 12.
Nasopharyngeal carcinoma (NPC) is a common malignant tumor of the head and neck, and is associated with high recurrence and low survival rates; however, distant brain metastasis from NPC is rare.
The authors report 3 cases of brain metastasis from NPC treated with stereotactic radiosurgery (SRS). A 49-year-old woman presented was diagnosed with brain metastasis from NPC, which occurred 53 months after the initial diagnosis of NPC. Brain magnetic resonance imaging (MRI) revealed a well-enhanced large tumor on the frontal lobe, which was treated with SRS. Six months later, brain MRI revealed progression of the tumor. A 44-year-old man had undergone craniotomy and removal of a cerebellar tumor pathologically confirmed as metastasis from NPC. The recurrent brain metastasis was diagnosed via routine MRI follow-up examination 23 months after surgery. Brain MRI revealed a heterogeneously enhanced cerebellar large tumor, which was treated using hypofractionated SRS. Three months later, brain MRI revealed a significant decrease in the tumor size. A 60-year-old man was diagnosed with distant brain metastasis from NPC via routine positron emission tomography follow-up examination 14 months after the initial diagnosis of NPC. Brain MRI confirmed a homogeneously enhanced tumor on the cavernous sinus, which was treated with SRS. Three months later, brain MRI revealed virtual disappearance of the tumor. All 3 patients had undergone concurrent chemoradiotherapy after the initial diagnosis of NPC and underwent salvage SRS for brain metastasis from NPC.
Despite the poor prognosis, salvage SRS was performed for these rare brain metastases from NPC.
鼻咽癌（NPC）是一种常见的头颈部恶性肿瘤，具有较高的复发率和较低的生存率；然而，NPC 远处脑转移较为罕见。
作者报告了 3 例 NPC 脑转移患者，他们接受了立体定向放射外科（SRS）治疗。一名 49 岁女性因 NPC 脑转移就诊，其在 NPC 初始诊断后 53 个月发生脑转移。脑磁共振成像（MRI）显示额叶有一个强化良好的大肿瘤，采用 SRS 治疗。6 个月后，脑 MRI 显示肿瘤进展。一名 44 岁男性曾行开颅术并切除小脑肿瘤，经病理证实为 NPC 转移。在手术后 23 个月，通过常规 MRI 随访检查诊断为复发性脑转移。脑 MRI 显示一个不均匀强化的小脑大肿瘤，采用分次 SRS 治疗。3 个月后，脑 MRI 显示肿瘤显著缩小。一名 60 岁男性在 NPC 初始诊断后 14 个月通过常规正电子发射断层扫描随访检查诊断为远处脑转移。脑 MRI 证实海绵窦有一个均匀强化的肿瘤，采用 SRS 治疗。3 个月后，脑 MRI 显示肿瘤几乎消失。所有 3 例患者在 NPC 初始诊断后均接受了同期放化疗，对 NPC 脑转移行挽救性 SRS 治疗。
尽管预后较差，但对这些罕见的 NPC 脑转移仍行挽救性 SRS 治疗。
