Yamaguchi T, Matsushima T, Miyake E, Fukui M, Suzuki S O, Matsuno H, Murata S
Department of Neurosurgery, Faculty of Medicine, Kyushu University.
No Shinkei Geka. 1995 Apr;23(4):333-7.
A case of long survival of brain tumor (well differentiated adenocarcinoma) was reported. A 55-year-old man was admitted in January, 1986, because of a one month history of progressive headache, dizziness and gait disturbance. CT scans revealed an enhancing tumor in contact with the falx in the right frontal lobe. The tumor was totally removed. The histopathological diagnosis was that of a well differentiated adenocarcinoma. The primary site of the adenocarcinoma was not detected. No chemotherapy or radiation therapy was given. Four years and 7 months after surgery CT scans demonstrated a recurrent tumor as a bilaterally expanding falx meningioma. Nearly total removal of the tumor was again performed and diagnosed as adenocarcinoma. Examinations to detect the primary site and other metastatic lesions were negative again. On May 1993, the patient died because of the intracranial dissemination of tumor without extracranial lesions. The period from the first operation to his death was 7 years and 5 months. This is a case of long survival of intracranial cancer, which was considered as a metastatic tumor, though the primary site and other metastatic lesions were not detected. The tumor in this case showed the atypical features of a metastatic adenocarcinoma. For example, the primary and recurrent tumors resembled a parasagital or falx meningioma in shape and they grew slowly. Therefore, there is a possibility that the tumor was actually a primary adenocarcinoma, which might have arisen from the embryologically migrated cells of the mucous membrane or from ectopic epithelial cells.
报告了一例脑肿瘤（高分化腺癌）长期存活的病例。一名55岁男性于1986年1月入院，因其有1个月的进行性头痛、头晕和步态障碍病史。CT扫描显示右额叶有一强化肿瘤，与大脑镰相连。肿瘤被完全切除。组织病理学诊断为高分化腺癌。未检测到腺癌的原发部位。未给予化疗或放疗。手术后4年7个月，CT扫描显示复发肿瘤为双侧生长的大脑镰脑膜瘤。再次几乎完全切除肿瘤，诊断为腺癌。检测原发部位和其他转移灶的检查结果再次为阴性。1993年5月，患者因肿瘤颅内播散死亡，无颅外病变。从首次手术到死亡的时间为7年5个月。这是一例颅内癌长期存活的病例，尽管未检测到原发部位和其他转移灶，但被认为是转移性肿瘤。该病例中的肿瘤表现出转移性腺癌的非典型特征。例如，原发肿瘤和复发肿瘤在形态上类似矢状旁或大脑镰脑膜瘤，且生长缓慢。因此，有可能该肿瘤实际上是原发性腺癌，可能起源于胚胎期迁移的黏膜细胞或异位上皮细胞。
