Yap H Y, Yap B S, Tashima C K, DiStefano A, Blumenschein G R
Cancer. 1978 Jul;42(1):283-6. doi: 10.1002/1097-0142(197807)42:1<283::aid-cncr2820420142>3.0.co;2-#.
Twenty-five breast cancer patients with meningeal carcinomatosis seen over a period of 16 months were reviewed. In all cases, the clinical diagnosis was made in the presence of diverse neurological manifestations by the demonstration of malignant cells in the cerebrospinal fluid. In ten patients, the clinical diagnosis was documented at autopsy. All patients were receiving systemic chemotherapy at the time the diagnosis of meningeal carcinomatosis was made. In 9 of the 25 patients, meningeal involvement was associated with progression of systemic metastases, while 5 exhibited stable or partial remission from systemic metastases and 7 were in complete remission at the time of their CNS relapse. CNS involvement was the first manifestation of recurrent disease from breast cancer in 4 of 25 patients. Meningeal involvement can, therefore, occur at any time during the course of breast cancer. With increasing diagnostic awareness and the employment of several therapeutic strategies, the prognosis of these patients, though poor, was significantly improved over that of historical control patients.
回顾了在16个月期间见到的25例患有脑膜癌病的乳腺癌患者。在所有病例中，通过脑脊液中恶性细胞的检测，在出现各种神经学表现的情况下做出了临床诊断。在10例患者中，临床诊断在尸检时得到证实。在做出脑膜癌病诊断时，所有患者均在接受全身化疗。25例患者中有9例脑膜受累与全身转移进展相关，5例全身转移表现为稳定或部分缓解，7例在中枢神经系统复发时处于完全缓解状态。25例患者中有4例中枢神经系统受累是乳腺癌复发性疾病的首发表现。因此，脑膜受累可发生在乳腺癌病程的任何时候。随着诊断意识的提高和多种治疗策略的应用，这些患者的预后虽然很差，但与历史对照患者相比有了显著改善。
