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胸腺瘤脑转移:罕见继发部位的病例报告

Brain metastases from a thymoma: Case report for a rare secondary localization.

作者信息

Gader Ghassen, Guediche Skander, Moussa Ines, Zekri Sinda Ben, Badri Mohamed, Harbaoui Ahmed, Zammel Ihsèn

机构信息

University of Tunis El-Manar, Faculty of Medicine of Tunis, Department of Neurosurgery, Trauma and Burns Center, Ben Arous, Tunisia.

University of Tunis El-Manar, Faculty of Medicine of Tunis, Department of Pneumology D, Abderrahmane Mami Hospital, Ariana, Tunisia.

出版信息

Radiol Case Rep. 2024 Aug 3;19(10):4531-4534. doi: 10.1016/j.radcr.2024.07.025. eCollection 2024 Oct.

Abstract

Thymomas are benign epithelial neoplasms originating from the thymus gland and are among the most common primary mediastinal tumors. Malignancy is typically determined by evidence of pathological invasion beyond the capsule, with local invasion being the primary mode of spread to adjacent organs. Distant metastases are exceedingly rare. We present the case of a 63-year-old man who exhibited symptoms suggestive of increased intracranial pressure and motor deficit. Brain imaging revealed multiple intracranial lesions. Surgical intervention was performed to excise the largest lesion. Subsequent body CT scan and pathological examination confirmed that the brain metastases originated from a primary thymoma, classified as B3. The patient was recommended for adjuvant chemotherapy and radiotherapy, but unfortunately passed away at the initiation of therapy. The prognosis for patients with brain metastases from thymomas remains poor. Optimal management strategies typically involve prompt surgical intervention whenever feasible, followed by adjuvant therapy aimed at improving mean survival rates.

摘要

胸腺瘤是起源于胸腺的良性上皮性肿瘤,是最常见的原发性纵隔肿瘤之一。恶性通常由超出包膜的病理侵犯证据确定,局部侵犯是扩散至相邻器官的主要方式。远处转移极为罕见。我们报告一例63岁男性,其表现出提示颅内压升高和运动功能障碍的症状。脑部影像学检查发现多个颅内病变。进行了手术干预以切除最大的病变。随后的全身CT扫描和病理检查证实脑转移瘤起源于原发性胸腺瘤,分类为B3型。建议该患者进行辅助化疗和放疗,但不幸的是在治疗开始时去世。胸腺瘤脑转移患者的预后仍然很差。最佳管理策略通常包括在可行时尽早进行手术干预,随后进行旨在提高平均生存率的辅助治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7296/11345126/2e1d8c2a9b59/gr1.jpg

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