Department of Neurology, Peking University Shenzhen Hospital, 518000, Shenzhen, China.
Department of Neurology, Shenzhen University First Affiliated Hospital, 3002 Sungang West Road, Futian District, 518000, Shenzhen, China.
BMC Neurol. 2021 Feb 8;21(1):59. doi: 10.1186/s12883-021-02088-w.
During medical imaging, cystic radiation encephalopathy and brain metastasis are difficult to differentiate, and hence they are easily misdiagnosed. To our knowledge, a nasopharyngeal carcinoma recurrence after more than seven years with cerebral metastasis that mimicked cystic radiation encephalopathy has not been reported.
A 52-year-old man was admitted to the hospital owing to weakness of the right limb for one month, which increased in intensity for three days. He had been diagnosed with nasopharyngeal carcinoma in 2011, which was treated by radiotherapy. The patient successively developed cystic radiation encephalopathy and brain metastasis from the nasopharyngeal carcinoma, which mimicked cystic radiation encephalopathy relapse. Left frontotemporal craniotomy, surgical resection of brain metastasis, and repair of the skull base and dura were performed. Postoperative computed tomography showed that midline deviation recovered, and brain edema was reduced.
This report is significant because brain metastasis from nasopharyngeal carcinoma can masquerade as a benign entity and cause fatal consequences. In patients presenting with cystic radiation encephalopathy, brain metastasis should be considered as a differential diagnosis.
在医学影像学中，囊性放射性脑病和脑转移瘤难以区分，因此容易误诊。据我们所知，在超过七年的时间后，复发性鼻咽癌伴发脑转移，且其表现类似于囊性放射性脑病，尚未见报道。
一名 52 岁男性，因右侧肢体无力 1 个月，加重 3 天入院。患者于 2011 年被诊断为鼻咽癌，行放疗治疗。此后，患者先后发生囊性放射性脑病和源于鼻咽癌的脑转移瘤，囊性放射性脑病复发。行左额颞开颅术，对脑转移瘤进行手术切除，并修复颅底和硬脑膜。术后 CT 显示，中线偏移恢复，脑水肿减轻。
本报告具有重要意义，因为鼻咽癌脑转移可伪装为良性病变，导致致命后果。对于表现为囊性放射性脑病的患者，应考虑脑转移瘤作为鉴别诊断。
