Yokota Akifumi, Ogiwara Toshihiro, Hanaoka Yoshiki, Higashiyama Fumiko, Oya Fusakazu, Horiuchi Tetsuyoshi
Department of Neurosurgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan.
Department of Neurosurgery, Shinshu Ueda Medical Center, Ueda 386-8610, Japan.
Radiol Case Rep. 2023 Mar 16;18(5):1939-1944. doi: 10.1016/j.radcr.2023.02.040. eCollection 2023 May.
Brain metastases of a chondrosarcoma are extremely rare, and treatment remains controversial. A 54-year-old woman had undergone surgical treatment for a femoral chondrosarcoma and its lung metastases. She presented with visual disturbance and dizziness 22 months after the initial surgery; imaging studies of the brain revealed a metastatic tumor in the left parieto-occipital lobe. Surgical tumor resection was performed; however, only 2 months after gross total resection of the tumor, rapid tumor recurrence was observed. Surgical resection was performed again, followed by intensity-modulated radiation therapy. Three months later, another small brain lesion was detected in the right parietal lobe and was treated with gamma knife stereotactic radiosurgery. No recurrence has been reported 20 months after this radiosurgery for brain metastasis. Thus, surgical treatment combined with several adequate radiation therapy sessions may be a viable treatment strategy for brain metastases of chondrosarcomas.
软骨肉瘤脑转移极为罕见,治疗仍存在争议。一名54岁女性曾接受股骨软骨肉瘤及其肺转移瘤的手术治疗。初次手术后22个月,她出现视力障碍和头晕;脑部影像学检查显示左顶枕叶有一个转移瘤。进行了手术肿瘤切除;然而,在肿瘤大体全切仅2个月后,就观察到肿瘤迅速复发。再次进行了手术切除,随后进行调强放射治疗。三个月后,在右顶叶又发现一个小的脑病灶,并接受了伽玛刀立体定向放射外科治疗。此次脑转移瘤放射外科治疗20个月后未报告复发。因此,手术治疗联合几次适当的放射治疗疗程可能是软骨肉瘤脑转移的一种可行治疗策略。