顱外腫瘤之脊髓軟腦膜轉移－病例報告

Spinal Leptomeningeal Metastasis by Systemic Cancer

陳信實(Sin-Sue Chen) ； 沈戊忠(Wu-Chung Shen) ； 韓念祖(Nien-Tsu Han) ； 楊建芳(Chien-Fang Yang) ； 張遵(Tsuen Chang)

《中華放射線醫學雜誌》 11卷4期 (1986/12) Pp. 327-331

摘要

顱外惡性腫瘤侵犯中樞神經系統的發生率約為12~24%，其中脊椎硬膜內病灶約佔6~8%，而軟脊膜浸潤型態者(Leptomeningeal infiltration)不到一半。然而近年來由於人壽的延長癌症罹患率相對的增加，此種稀少的轉移現象亦有漸增的趨勢。吾人應當對此症有所認知，期能早期診斷與治療並緩解病人症狀。本文報告一例肺癌病人產生馬尾神經東的軟脊膜轉移，暨提出其臨床、手術、病理、放射線學檢查及屍體解剖的發現，並回溯文獻加以討論。

並列摘要

Spinal leptomeningeal metastasis caused by systemic malignancy other than brain tumors is rare. Although the frequency and the routes of cerebral leptomeningeal metastasis are agreed by most authorities and well documented, the aspect of spinal form remain a matter of controversy. In recent years, effective treatment has resulted in striking prolongation of survival in patients with systemic malignancy. Thus, with increased frequency and survival times of cancer patients, there will be more often for radiological practice to observe the rare mode of metastasis. It is important for us to aware of this phenomenon in order to early detection, diagnosis and treatment. We report a case of bronchogenic carcinoma with leptomeningeal metastasis along the nerve roots of cauda equina. The clinicopathological data, operative finding and radiographic picture are presented The literature and pathogenesis are briefly reviewed.