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宫颈小细胞神经内分泌癌伴软脑膜播散:一例罕见病例报告及文献综述

Small-cell neuroendocrine carcinoma of the cervix with leptomeningeal spread: A rare coincidence report and literature review.

作者信息

Azab Mohammed A, Atallah Oday, El-Gohary Nour, Hazim Ahmed, Mostafa Hamed Abdelma'aboud

机构信息

Department of Neurosurgery, Cairo University Hospital, Cairo, Egypt.

Department of Neurosurgery, Hannover Medical School, Hannover Medical School, Hannover, Germany.

出版信息

Surg Neurol Int. 2024 Aug 30;15:310. doi: 10.25259/SNI_431_2024. eCollection 2024.

Abstract

BACKGROUND

Metastasis from cancers of the cervix to the central nervous system is relatively uncommon. Small-cell neuroendocrine cancer of the cervix is a very rare tumor with a high tendency to spread early.

CASE DESCRIPTION

A 33-year-old-woman was diagnosed with a small-cell neuroendocrine cancer of the cervix after complaining about a long time of post-coital bleeding. The patient was treated with eight cycles of chemotherapy and whole pelvis consolidation radiotherapy. One year later, the patient experienced local recurrence with metastases to the liver, left adrenal, and brain. Brain metastases were treated with radiosurgery. The patient started immunotherapy. Two months later, the patient was presented to the emergency department with urinary incontinence, neck pain, and difficulty walking. She was then diagnosed with craniospinal leptomeningeal disease (LMD). The patient received craniospinal palliative radiation therapy. The disease activity was severely progressive, and the patient passed out within 10 days after being diagnosed with cranial LMD.

CONCLUSION

A high index of suspicion for LMD is essential in patients diagnosed with cervix cancer who present with unexplained neurologic symptoms, especially with the high-grade neuroendocrine cancer type. Implementing robust research to uncover the biology of these aggressive tumors is important due to the rarity of this pathology.

摘要

背景

宫颈癌转移至中枢神经系统相对少见。宫颈小细胞神经内分泌癌是一种非常罕见的肿瘤,具有早期高转移倾向。

病例描述

一名33岁女性因长期性交后出血就诊,被诊断为宫颈小细胞神经内分泌癌。患者接受了8个周期的化疗及全盆腔巩固放疗。1年后,患者出现局部复发并伴有肝、左肾上腺及脑转移。脑转移采用立体定向放射治疗。患者开始接受免疫治疗。两个月后,患者因尿失禁、颈部疼痛及行走困难就诊于急诊科。随后被诊断为颅脊髓软脑膜疾病(LMD)。患者接受了颅脊髓姑息性放射治疗。疾病进展迅速,患者在被诊断为颅脑LMD后10天内死亡。

结论

对于诊断为宫颈癌且出现无法解释的神经症状的患者,尤其是高级别神经内分泌癌类型,高度怀疑LMD至关重要。由于这种病理情况罕见,开展深入研究以揭示这些侵袭性肿瘤的生物学特性很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9193/11380899/b6a446edc1d9/SNI-15-310-g001.jpg

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