Wang Tianhong, Pu Kuairong, Lin Xiwen, Li Zhe, Wu Jun, Shao Dongchuan, Zhao Nan
Department of Neurosurgery, Jinning District People's Hospital, Kunming, China.
Department of Neurosurgery, First People's Hospital of Kunming, Kunming, China.
Ann Med Surg (Lond). 2024 Sep 10;87(3):1652-1655. doi: 10.1097/MS9.0000000000002557. eCollection 2025 Mar.
Pancreatic cancer metastasis to the cerebellopontine angle (CPA) is extremely rare and often misdiagnosed preoperatively. The clinical characteristics and prognosis of this uncommon condition remain largely unknown.
We report the case of a 68-year-old male who presented with recurrent headaches, dizziness, and gait disturbances. The patient had undergone pancreaticoduodenectomy for pancreatic head adenocarcinoma two years prior. Preoperative imaging suggested a right CPA meningioma. The patient underwent resection of the CPA tumor under general anesthesia. Postoperative pathology revealed a metastatic pancreatic adenocarcinoma. Despite treatment with adjuvant chemotherapy, the patient developed widespread metastatic disease and succumbed 2 months after the CPA tumor resection.
The rarity of pancreatic cancer metastasizing to the CPA presents diagnostic challenges, as evidenced by the initial misdiagnosis of meningioma in this case. The clinical presentation can mimic benign conditions, leading to delays in appropriate management. This case underscores the importance of considering metastatic disease in patients with a history of cancer, even when presenting with symptoms typical of more common CPA lesions.
Vigilant monitoring is crucial in pancreatic cancer patients, as neurological symptoms may herald metastatic spread to uncommon sites like the CPA. Despite surgical intervention, widespread metastasis can lead to poor outcomes. Early diagnosis and a high index of suspicion are essential for optimal management of these rare cases.
胰腺癌转移至桥小脑角（CPA）极为罕见，术前常被误诊。这种罕见情况的临床特征和预后在很大程度上仍不为人知。
我们报告一例68岁男性，表现为反复头痛、头晕和步态障碍。该患者两年前因胰头腺癌接受了胰十二指肠切除术。术前影像学检查提示右侧CPA脑膜瘤。患者在全身麻醉下接受了CPA肿瘤切除术。术后病理显示为转移性胰腺腺癌。尽管接受了辅助化疗，患者仍出现广泛转移，并在CPA肿瘤切除术后2个月死亡。
胰腺癌转移至CPA的罕见性带来了诊断挑战，本病例最初误诊为脑膜瘤就证明了这一点。临床表现可能类似良性疾病，导致适当治疗延迟。该病例强调了在有癌症病史的患者中考虑转移性疾病的重要性，即使其症状为更常见的CPA病变所特有。
对胰腺癌患者进行警惕监测至关重要，因为神经症状可能预示着转移至如CPA这样的罕见部位。尽管进行了手术干预，广泛转移仍可能导致不良预后。早期诊断和高度怀疑指数对于这些罕见病例的最佳管理至关重要。
