Cormio G, Lissoni A, Losa G, Zanetta G, Pellegrino A, Mangioni C
Department of Obstetrics and Gynecology, University of Milan, Istituto di Scienze Biomediche, Monza, Italy.
Gynecol Oncol. 1996 Apr;61(1):40-3. doi: 10.1006/gyno.1996.0093.
Central nervous system (CNS) involvement by endometrial carcinoma is uncommon. Among 1069 patients registered for endometrial carcinoma at our institution between 1982 and 1994, 10 (0,9%) developed brain metastases. Median age at the time of CNS metastasis diagnosis was 59 years. Median interval between diagnosis of endometrial cancer and documentation of brain involvement was 26 months. Clinical manifestation of brain metastasis included headache (80%), motor weakness (50%), seizures (20%), confusion (10%), balance (10%), and visual disturbances (10%). All lesions (4 multiple, 6 single) were contrast enhancing on computed tomography (CT) scans, and were located in the cerebrum in seven cases, in the cerebellum in one case, and in both in two cases. The CNS was the only site of detectable disease in six patients with recurrent disease. Nine patients died and one is alive with disease 3 months after surgical resection of a single cerebral deposit. Median survival from diagnosis of brain metastases for the entire series was 1 month (range 1-83). Six patients receiving only steroids died within 1 month from the diagnosis. One patient received radiotherapy (survival, 3 months) and two underwent surgical resection of solitary metastasis followed by radiotherapy (survival = 28 and 83 months). Prognosis of patients with CNS metastases from endometrial carcinoma appears poor; however, in a selected group of patients early diagnosis followed by multimodal treatment may result in a palliation of the disease.
子宫内膜癌累及中枢神经系统（CNS）并不常见。1982年至1994年间，在我们机构登记的1069例子宫内膜癌患者中，有10例（0.9%）发生了脑转移。CNS转移诊断时的中位年龄为59岁。子宫内膜癌诊断与脑转移记录之间的中位间隔时间为26个月。脑转移的临床表现包括头痛（80%）、运动无力（50%）、癫痫发作（20%）神志不清（10%）、平衡障碍（10%）和视觉障碍（10%）。所有病灶（4个多发，6个单发）在计算机断层扫描（CT）上均有强化，7例位于大脑，1例位于小脑，2例大脑和小脑均有病灶。在6例复发患者中，CNS是唯一可检测到疾病的部位。9例患者死亡，1例在手术切除单个脑转移灶3个月后仍存活。整个系列中脑转移诊断后的中位生存期为1个月（范围1 - 83个月）。仅接受类固醇治疗的6例患者在诊断后1个月内死亡。1例患者接受了放疗（生存期3个月），2例接受了孤立转移灶的手术切除，随后进行放疗（生存期分别为28个月和83个月）。子宫内膜癌CNS转移患者的预后似乎很差；然而，在一组经过挑选的患者中，早期诊断并进行多模式治疗可能会使病情得到缓解。
