Kato Takahisa, Tsurukiri Junya, Sano Hidefumi, Nagura Takeo, Moriya Mariko, Suenaga Hiroki, Matsunaga Kyosuke, Kanemura Takeshi, Ueta Yuki, Arai Takao
Department of Emergency and Critical Care Medicine, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
Department of Neurology, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
JMA J. 2022 Jan 17;5(1):151-156. doi: 10.31662/jmaj.2021-0108. Epub 2021 Dec 28.
Salivary duct carcinoma (SDC) is a rare and highly aggressive salivary gland tumor with rapid growth, distant metastasis, and a high recurrence rate. Moreover, the parotid gland is the most common site with a poor prognosis. A lower frequency of distance metastasis to the liver, skin, and brain has also been reported, although the lungs, bones, and lymph nodes are the most common sites of SDC metastasis. We report a case of nonconvulsive status epilepticus (NCSE) in a 73-year-old male comatose patient having SDC of the parotid gland with an unusual metastasis to the skin and brain diagnosed by frequent cerebrospinal fluid examinations. Meningeal carcinomatosis usually has a poor prognosis, and NCSE is a reversible cause of altered mentation. Clinicians should know the unique set of epilepsy etiologies in patients with malignant tumors.
涎腺导管癌(SDC)是一种罕见且侵袭性很强的涎腺肿瘤,生长迅速,易发生远处转移,复发率高。此外,腮腺是最常见的发病部位,预后较差。虽然肺、骨和淋巴结是SDC转移最常见的部位,但也有报道称其转移至肝脏、皮肤和脑的频率较低。我们报告一例73岁男性昏迷患者,患有腮腺SDC并伴有不寻常的皮肤和脑转移,通过频繁的脑脊液检查诊断为非惊厥性癫痫持续状态(NCSE)。脑膜癌病通常预后较差,而NCSE是精神状态改变的可逆原因。临床医生应了解恶性肿瘤患者癫痫病因的独特情况。