Hettrick Daniel, Harrison Snyder M, Arkun Knarik, Jeyapalan Suriya, Gonzalez Rafael, Mignano John, Roguski Marie
Tufts School of Medicine, Tufts University, Boston, Massachusetts.
Departments of Neurosurgery, Tufts Medical Center, Boston, Massachusetts.
J Neurosurg Case Lessons. 2024 Dec 9;8(24). doi: 10.3171/CASE24513.
Endometrial papillary serous carcinoma (EPSC) is a rare gynecological malignancy that often metastasizes before the presentation of symptoms or diagnosis of the primary disease. The most common locations of metastases for this malignancy are the lungs, liver, and bones. Metastases to the central nervous system (CNS) are rare. Solitary CNS metastases without other anatomical site spread are exceedingly rare.
A 65-year-old female with a past medical history of EPSC presented with right-sided weakness, gait instability, and progressive dysarthria. Neurological evaluation revealed right hemiparesis and dysarthria. Head computed tomography showed an ovoid area of hypoattenuation in the left pons. Magnetic resonance imaging confirmed a 2.6-cm pontine lesion. A biopsy revealed histomorphology and immunophenotype consistent with metastasis of previously diagnosed serous carcinoma of the endometrium.
Gynecological malignancies, in particular EPSC, can metastasize to atypical locations even without evidence of systemic disease. The authors hypothesize that this may be due to hematogenous spread through the Batson venous plexus. https://thejns.org/doi/10.3171/CASE24513.
子宫内膜浆液性乳头状癌（EPSC）是一种罕见的妇科恶性肿瘤，常在出现症状或原发性疾病诊断之前发生转移。这种恶性肿瘤最常见的转移部位是肺、肝和骨。转移至中枢神经系统（CNS）较为罕见。无其他解剖部位扩散的孤立性CNS转移极为罕见。
一名有EPSC既往病史的65岁女性出现右侧肢体无力、步态不稳和进行性构音障碍。神经学评估显示右侧偏瘫和构音障碍。头部计算机断层扫描显示左侧脑桥有一个椭圆形低密度区。磁共振成像证实有一个2.6厘米的脑桥病变。活检显示组织形态学和免疫表型与先前诊断的子宫内膜浆液性癌转移相符。
妇科恶性肿瘤，尤其是EPSC，即使没有全身性疾病的证据也可转移至非典型部位。作者推测这可能是由于通过Batson静脉丛的血行播散所致。https://thejns.org/doi/10.3171/CASE24513 。
