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[以加欣综合征为表现的胃癌颅底转移——一例报告]

[Basal skull metastasis of stomach cancer presenting with Garcin's syndrome--a case report].

作者信息

Harada S, Toya S, Iisaka Y, Ohtani M, Nakamura Y

机构信息

Department of Neurosurgery, School of Medicine, Keio University, Tokyo, Japan.

出版信息

No Shinkei Geka. 1987 Jul;15(7):765-9.

PMID:3670546
Abstract

A case of 57-year-old man with Garcin's syndrome is reported. By means of upper gastrointestinal endoscopy, this patient proved to have a stomach cancer. He noticed left trigeminal neuralgia for the first time in early Jan. 1986, and when he was referred to our department, his symptoms and signs of left cranial nerve palsy (from 5th to 12th, totally 8 nerves) were complete, although other neurological findings such as long tract signs, cerebellar signs, or papilledema were all negative. Although skull X-ray and basal skull tomography revealed neither bony deformity nor destruction, CT scan and angiography showed suspicious appearance of basal skull invasion of a certain mass. CSF examination revealed no malignant cells or abnormal protein, and sugar content. Exploratory craniotomy for tumor biopsy was performed. Histologically, the tumor had characteristics of anaplastic carcinoma. General survey revealed that he had a stomach cancer which was histologically the same as the basal skull tumor. His general condition became so serious that irradiation to the lesion was not indicated Among many papers reported about Garcin's syndrome, those of basal skull metastasis of stomach cancer are extremely rare. The authors discussed the lesion in comparison with meningeal carcinomatosis involving cranial nerves.

摘要

报告一例57岁患有加欣综合征的男性病例。通过上消化道内镜检查,该患者被证实患有胃癌。他于1986年1月初首次出现左侧三叉神经痛,当他被转诊至我科时,其左侧颅神经麻痹(从第5对到第12对,共8条神经)的症状和体征已完全出现,尽管其他神经系统表现如长束征、小脑征或视乳头水肿均为阴性。尽管头颅X线和颅底断层扫描均未显示骨质畸形或破坏,但CT扫描和血管造影显示某一肿块有可疑的颅底侵犯表现。脑脊液检查未发现恶性细胞、异常蛋白及糖含量异常。遂进行了开颅肿瘤活检。组织学检查显示,肿瘤具有间变性癌的特征。全面检查发现他患有胃癌,其组织学类型与颅底肿瘤相同。他的一般状况变得非常严重,以至于不适合对病变进行放疗。在众多关于加欣综合征的报道中,胃癌颅底转移的病例极为罕见。作者将该病变与累及颅神经的脑膜癌病进行了比较讨论。

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