Maeshima Kazuhide, Sasaki Takahiro, Yamoto Toshikazu, Fukai Junya, Nishibayashi Hiroki, Nakao Naoyuki
Department of Neurological Surgery, Wakayama Medical University, Wakayama, Japan.
Surg Neurol Int. 2022 Jan 20;13:20. doi: 10.25259/SNI_1130_2021. eCollection 2022.
Small-cell carcinoma of the urinary bladder (SCCB) accounts for 1% of all bladder tumors. We present a rare case of hemorrhagic metastatic brain tumor from SCCB diagnosed by navigation-guided endoscopic biopsy.
A 76-year-old man presented with sudden onset of aphasia and right hemiplegia from 3 weeks previously. He had a medical history of prostate cancer and SCCB. Computed tomography showed a mixed density mass in the left basal ganglia. On magnetic resonance imaging, the mass showed mixed intensity in both T1-weighted images and T2-weighted images, suggesting subacute hemorrhage. The mass was partially enhanced with gadolinium. The patient underwent endoscopic hematoma evacuation and partial removal of the tumor. Histopathological diagnosis was neuroendocrine carcinoma, which was consistent with SCCB metastasis. After surgery, the patient underwent whole-brain radiation therapy of 30 Gy. His general condition gradually deteriorated, however, and he died 4 months after surgery.
Our patient had a rare case of brain metastasis derived from SCCB which presented with cerebral hemorrhage. Navigation-guided endoscopic biopsy was useful for the diagnostic sampling of deep localized brain tumors with hemorrhage.
膀胱小细胞癌（SCCB）占所有膀胱肿瘤的1%。我们报告一例罕见的经导航引导内镜活检诊断的膀胱小细胞癌出血性脑转移瘤病例。
一名76岁男性，3周前突然出现失语和右侧偏瘫。他有前列腺癌和膀胱小细胞癌病史。计算机断层扫描显示左侧基底节区有一个混合密度肿块。在磁共振成像中，该肿块在T1加权像和T2加权像上均显示混合信号强度，提示亚急性出血。肿块用钆剂部分强化。患者接受了内镜下血肿清除和肿瘤部分切除。组织病理学诊断为神经内分泌癌，与膀胱小细胞癌转移一致。术后，患者接受了30 Gy的全脑放射治疗。然而，他的一般状况逐渐恶化，术后4个月死亡。
我们的患者是一例罕见的源自膀胱小细胞癌并伴有脑出血的脑转移病例。导航引导内镜活检对于伴有出血的深部脑肿瘤的诊断性取材是有用的。
