Sagoh M, Kodaki K, Ichikizaki K, Murakami K, Oizumi T, Kawase T, Toya S, Shiga H
Department of Neurosurgery, School of Medicine, Keio University.
No Shinkei Geka. 1996 Sep;24(9):829-33.
We report two cases of skull base metastasis from renal cell carcinoma. Case 1: A 55-year-old female presented with a skull base tumor located on the clivus. Partial removal of the tumor was performed via the transsphenoidal approach. Case 2: A 44-year-old male presented with a skull base tumor occupying the orbital, nasal, and paranasal cavities. The first operation, partial removal of the tumor, was performed via the transsphenoidal approach. Thereafter, the tumor regrowth and the patient's symptoms were progressive, so a second operation was performed via Le-Forte I craniotomy to prevent cranial nerve dysfunction and air way obstruction. The initial symptom of these two cases was abducens nerve paresis, which is caused by the tumor extending from the clivus to the cavernous sinus. The neuroradiological features were the destruction of skull base bone and angiographic tumor stain. Histopathological examination of the surgically resected specimens revealed clear cell carcinoma, and thereafter they were diagnosed as skull base metastasis from renal cell carcinoma. We emphasize the necessity of a thorough medical workup to enable speedy diagnosis of renal cell carcinoma in such cases.
我们报告了两例肾细胞癌颅底转移的病例。病例1：一名55岁女性，表现为位于斜坡的颅底肿瘤。通过经蝶窦入路对肿瘤进行了部分切除。病例2：一名44岁男性，表现为占据眼眶、鼻腔和鼻窦腔的颅底肿瘤。首次手术，通过经蝶窦入路对肿瘤进行了部分切除。此后，肿瘤复发且患者症状呈进行性发展，因此通过Le-Forte I开颅术进行了第二次手术，以防止颅神经功能障碍和气道阻塞。这两例的初始症状均为外展神经麻痹，这是由肿瘤从斜坡延伸至海绵窦所致。神经放射学特征为颅底骨质破坏和血管造影肿瘤染色。对手术切除标本进行组织病理学检查显示为透明细胞癌，此后它们被诊断为肾细胞癌颅底转移。我们强调在此类病例中进行全面医学检查以实现肾细胞癌快速诊断的必要性。
