Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
In Vivo. 2024 Sep-Oct;38(5):2557-2561. doi: 10.21873/invivo.13730.
BACKGROUND/AIM: Although chemotherapy for colorectal cancer has advanced remarkably, long-term chemotherapy can lead to a variety of infections. However, if chemotherapy must be discontinued to control infection, there is a risk of progression of colorectal cancer. Intracranial subdural empyema is a life-threatening intracranial infection. The condition requires 6-8 weeks of antibiotic therapy, and the patient must discontinue chemotherapy during treatment. We herein present a case of intracranial subdural empyema during long-term chemotherapy for metastatic rectal cancer.
A 69-year-old woman with unresectable metastatic rectal cancer had a convulsive seizure and was admitted to our hospital. The cause of the convulsive seizure was considered a metastatic brain tumor from rectal cancer. However, on the basis of contrast-enhanced computed tomography and contrast-enhanced magnetic resonance imaging, we diagnosed intracranial subdural empyema. The infection was controlled by antibiotics, but chemotherapy for rectal cancer was discontinued during antibiotic treatment. As a result, the rectal cancer progressed, and the patient died 65 days after admission to our hospital.
Intracranial subdural empyema may develop rarely during chemotherapy. This condition requires long-term treatment with antibiotics; therefore, early detailed imaging and diagnosis may improve the prognosis.
背景/目的：尽管结直肠癌的化疗有了显著进展，但长期化疗可能会导致各种感染。然而，如果为了控制感染而停止化疗，结直肠癌可能会进展。颅内硬膜下积脓是一种危及生命的颅内感染，需要 6-8 周的抗生素治疗，治疗期间患者必须停止化疗。本文报告了一例转移性直肠癌长期化疗期间发生颅内硬膜下积脓的病例。
一名 69 岁女性患有不可切除的转移性直肠腺癌，出现癫痫发作并被收入我院。癫痫发作的原因被认为是直肠癌脑转移瘤。然而，基于增强 CT 和增强 MRI，我们诊断为颅内硬膜下积脓。通过抗生素控制感染，但在抗生素治疗期间停止了直肠癌化疗。结果，直肠癌进展，患者在入院后 65 天死亡。
颅内硬膜下积脓在化疗期间可能很少发生。这种情况需要长期抗生素治疗；因此，早期详细的影像学和诊断可能会改善预后。
