Jang Anthony I, Bernstock Joshua D, Segar David J, Distasio Marcello, Matulonis Ursula, Bi Wenya Linda
Harvard Medical School, Boston, MA, United States.
Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States.
Front Surg. 2021 Feb 17;8:594570. doi: 10.3389/fsurg.2021.594570. eCollection 2021.
Metastatic brain tumors typically arise from primary malignancies of the lung, kidney, breast, skin, and colorectum. Brain metastases originating from malignancies of the female genital tract are extremely rare. We present a case of fallopian tube brain metastasis and in so doing review the pertinent literature. We describe a 59-year-old patient with a history of fallopian tube carcinoma who presented with an incidentally identified left frontal brain mass. MRI demonstrated an enhancing lesion in the left centrum semiovale with a second enhancing lesion noted in the cerebellar vermis. She underwent a left parietal craniotomy for resection of the dominant and clinically symptomatic lesion. Immunohistochemical stains were positive for PAX8 and p53, confirming fallopian tube origin. Fallopian tube cancer brain metastasis is extremely uncommon. We highlight the treatment and surgical resection of this patient's metastatic fallopian lesion and systematically review the literature regarding the pathogenesis, diagnosis, treatment, and histologic characteristics of the previously identified fallopian tube metastases to the central nervous system. The optimal course of treatment for brain metastasis of fallopian tube carcinoma has not been clearly defined due in part to the rarity of this condition. Consistent with neoplasms involving the breast and ovaries, the status of the patient's primary tumor likely increased the risk of central nervous system dissemination. This highlights a potential benefit of early screening of individuals with metastatic gynecologic malignancies associated with in the absence of any neurological symptoms.
转移性脑肿瘤通常起源于肺、肾、乳腺、皮肤和结肠直肠的原发性恶性肿瘤。源自女性生殖道恶性肿瘤的脑转移极为罕见。我们报告一例输卵管脑转移病例，并对相关文献进行综述。我们描述了一名59岁有输卵管癌病史的患者，其偶然发现左侧额叶脑肿块。磁共振成像（MRI）显示左侧半卵圆中心有一强化病灶，小脑蚓部还有第二个强化病灶。她接受了左侧顶骨开颅手术，以切除主要的且有临床症状的病灶。免疫组化染色PAX8和p53呈阳性，证实为输卵管起源。输卵管癌脑转移极为罕见。我们着重介绍了该患者转移性输卵管病灶的治疗及手术切除情况，并系统回顾了此前已确定的输卵管转移至中枢神经系统的发病机制、诊断、治疗及组织学特征的相关文献。由于这种情况罕见，输卵管癌脑转移的最佳治疗方案尚未明确界定。与涉及乳腺和卵巢的肿瘤一致，患者原发肿瘤的状况可能增加了中枢神经系统播散的风险。这凸显了在没有任何神经症状的情况下，对患有转移性妇科恶性肿瘤的个体进行早期筛查的潜在益处。
