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鼻咽癌合并脑膜转移经长期综合治疗后长期生存:1 例报告并文献复习。

Nasopharyngeal carcinoma with leptomeningeal metastases has been treated with comprehensive treatment for long-term survival: A case report and literature review.

机构信息

Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.

出版信息

Medicine (Baltimore). 2024 Jun 7;103(23):e37853. doi: 10.1097/MD.0000000000037853.

Abstract

RATIONALE

Nasopharyngeal carcinoma has a high incidence in East and Southeast Asia, often with distant metastasis. However, leptomeningeal metastasis (LM) is extremely rare and usually has a poor prognosis. This paper reports the clinical treatment of a patient with meningeal metastasis of nasopharyngeal carcinoma (NPC) in order to improve the clinician's understanding of the disease. Early diagnosis of the disease can alleviate the pain of patients and prolong their survival time.

PATIENT CONCERNS

We report the case of a 55-year-old female with a history of NPC with LM. Brain magnetic resonance imaging showed temporal lobe enhancement, peripheral edema, and enhancement of the adjacent meninges. Cerebrospinal fluid cytology suggests the presence of malignant tumor cells.

DIAGNOSES

The patient was diagnosed with LM from NPC.

INTERVENTIONS

The patients were regularly given targeted therapy with nimotuzumab, immunotherapy with karyolizumab, and lumbar intrathecal methotrexate chemotherapy and supportive treatment.

OUTCOMES

The patient had survived for 3 years since the diagnosis of LM and was in good condition and still under active antitumor treatment.

LESSONS

Leptomeningeal metastasis of NPC is a rare disease. Although there is currently no unified treatment plan, the neurological symptoms can still be controlled and the quality of life can be improved through active treatment.

摘要

背景

鼻咽癌在东亚和东南亚地区发病率较高,常伴有远处转移。然而,脑膜转移(LM)极为罕见,通常预后较差。本文报告了 1 例鼻咽癌脑膜转移患者的临床治疗情况,旨在提高临床医生对该病的认识。早期诊断可减轻患者痛苦,延长其生存时间。

病例描述

我们报告了 1 例 55 岁女性鼻咽癌伴 LM 病史。头颅磁共振成像显示颞叶强化,周围水肿,相邻脑膜强化。脑脊液细胞学提示存在恶性肿瘤细胞。

诊断

患者被诊断为鼻咽癌脑膜转移。

治疗措施

患者定期接受尼妥珠单抗靶向治疗、卡瑞利珠单抗免疫治疗、腰椎鞘内注射甲氨蝶呤化疗及支持治疗。

治疗结果

患者自诊断为 LM 以来已存活 3 年,病情良好,仍在积极抗肿瘤治疗中。

结论

鼻咽癌脑膜转移较为罕见。目前虽尚无统一的治疗方案,但通过积极治疗仍可控制神经症状,提高生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e20b/11155548/6513b68795cf/medi-103-e37853-g001.jpg

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