Department of Gynecologic Oncology, Hyogo Cancer Center, 13-70 Kitaoji-cho, Akashi, Hyogo, 673-8558, Japan.
Int J Clin Oncol. 2020 Feb;25(2):391-395. doi: 10.1007/s10147-019-01556-1. Epub 2019 Oct 4.
Most cases of leptomeningeal metastasis (LM) arise from solid tumors, such as breast cancer, lung cancer, or malignant melanoma. LM arising from gynecological cancers are extremely rare. Longer survival owing to recent advances in chemotherapy and other treatments has contributed to the increased frequency of gynecological cancers metastasizing to the central nervous system (CNS). Detailed information regarding LM is scarce; therefore, we conducted a study concerning LM arising from primary gynecological cancers.
Among 24 patients with CNS metastases from gynecological cancer treated at our hospital between January 2011 and August 2018, those who were eventually diagnosed with LM were included in this retrospective study.
Among 24 patients with CNS metastases, five patients (20.8%) were diagnosed with LM. The primary cancer was endometrial in two, cervical in one, and peritoneal in two patients. Of these five patients, three developed LM as a complication 1-11 months after the treatment of brain metastases; one patient had multiple brain metastases diagnosed at the same time as LM, and one had LM alone, without accompanying brain metastases. The median survival after the diagnosis of LM was 23 (12-69) days, while the median survival of 24 patients after the initial diagnosis of CNS metastases was 106 (13-959) days.
Although LM arising from gynecological cancers is considered rare, identification of LM may be important to predict prognosis and develop new therapeutic strategies.
大多数脑膜转移（LM）病例源于实体瘤，如乳腺癌、肺癌或恶性黑色素瘤。源自妇科癌症的 LM 极为罕见。由于最近化疗和其他治疗方法的进步，患者的生存期延长，导致妇科癌症向中枢神经系统（CNS）转移的频率增加。关于 LM 的详细信息很少；因此，我们进行了一项关于源自原发性妇科癌症的 LM 的研究。
在 2011 年 1 月至 2018 年 8 月期间，在我院接受 CNS 转移治疗的 24 名妇科癌症患者中，最终诊断为 LM 的患者被纳入本回顾性研究。
在 24 名 CNS 转移患者中，有 5 名（20.8%）被诊断为 LM。原发癌症为子宫内膜癌 2 例，宫颈癌 1 例，腹膜癌 2 例。这 5 名患者中，有 3 名在脑转移治疗后 1-11 个月出现 LM 并发症；1 名患者同时诊断出多发脑转移和 LM，1 名患者仅有 LM，无脑转移。LM 诊断后的中位生存期为 23（12-69）天，而 24 名患者 CNS 转移初始诊断后的中位生存期为 106（13-959）天。
虽然源自妇科癌症的 LM 被认为罕见，但识别 LM 可能对预测预后和制定新的治疗策略很重要。
