Omofoye Oluwaseun A, Binello Emanuela
Department of Neurosurgery, University of California, Davis, Sacramento, CA 95817, USA.
Department of Neurosurgery, Boston Medical Center, Boston, MA 02118, USA.
J Biomed Res. 2019 Aug 28;34(4):318-322. doi: 10.7555/JBR.33.20180133.
Intraventricular metastases are a rare occurrence, particularly from a primary colorectal malignancy. To our knowledge, this is the first report of intraventricular metastasis from rectal cancer. A 72-year-old male presented with a new diagnosis of multiple intraventricular lesions, an anterior mediastinal mass and a rectal mass. His workup revealed rectal adenocarcinoma with intraventricular metastases and an incidental thymoma. Ommaya reservoir placement was performed an awake procedure rather than under general anesthesia due to airway concerns. Cerebrospinal fluid (CSF) cytology was positive for malignancy and consistent with adenocarcinoma. Two weeks postoperatively, the patient underwent whole brain radiation. Although rare, this diagnosis should always be considered in the differential for solitary or multiple intraventricular lesions. CSF sampling is a useful alternative to intraventricular biopsy for diagnosis of intraventricular metastases. Awake placement of Ommaya reservoir is a safe option in the management of patients with intraventricular metastases, especially those who cannot undergo general anesthesia.
脑室内转移瘤较为罕见，尤其是源于原发性结直肠癌的情况。据我们所知，这是首例直肠癌脑室内转移的报告。一名72岁男性被新诊断出患有多个脑室内病变、前纵隔肿块和直肠肿块。他的检查显示为直肠腺癌伴脑室内转移以及偶然发现的胸腺瘤。由于气道问题，奥马亚贮液器置入术是在清醒状态下进行的，而非全身麻醉下进行。脑脊液（CSF）细胞学检查显示恶性肿瘤阳性，且与腺癌相符。术后两周，患者接受了全脑放疗。尽管罕见，但在鉴别孤立性或多发性脑室内病变时，始终应考虑这一诊断。脑脊液采样是诊断脑室内转移瘤的一种有用的替代脑室内活检的方法。清醒状态下置入奥马亚贮液器是管理脑室内转移瘤患者的一种安全选择，尤其是那些无法接受全身麻醉的患者。
