Spinal Cord Drop Metastasis of Intracranial Oligodendroglioma: A Case Report

顱內寡樹突神經膠質瘤之下移性脊髓轉移：一病例報告

張世宗(Shih-Tshung Chang) ； 劉文山(Wen-Shan Liu)

《放射治療與腫瘤學》 11卷1期 (2004/03) Pp. 65-69

https://doi.org/10.6316/TRO/200411(1)65

摘要

目的：顱內寡樹突神經膠質瘤伴隨下移性脊髓轉移是不常見的病例，我們報告一例病患及其接受放射線治療的效果。 病例報告：一位年齡49歲的男性罹患左大腦顳葉寡樹突神經膠質瘤，於1999年接受大腦腫瘤切除手術及術後放射線治療。不幸的，在2002年時，於小腦蚓部及延髓處發現局部復發的情形。之後，針對腦部復發部位，他接受了一個療程的經動脈注入之化學治療。在那同時，病人也自訴有持續十個多月嚴重的下背疼痛伴隨左側坐骨神經痛。隨後在病人的腰椎部位發現腫瘤，病理診斷為轉移性寡樹突神經膠質瘤。於是切除了轉移的腫瘤，並在腰椎第二節至薦椎第三節給予術後放射線治療。從2003年1月至2003年2月，共接受了55 Gy計51次41天照射。 結果：在接受了完整的放射線療程之後，病人的下背疼痛及左側坐骨神經痛等症狀都獲得了明顯的改善。持續7個月的追蹤撿查，腰薦椎的患處並無任何明顯的惡化情形。 結論：從1942年到2002年，世界文獻上僅只有8個顱內寡樹突神經膠質瘤之下移性脊髓轉移病例被報告。由我們報告病例的經驗中可知，轉移腫瘤所造成的神經壓迫症狀可經由放射線治療獲的良好的改善。

關鍵字

寡樹突神經膠質瘤 ； 脊髓轉移 ； 放射線治療

並列摘要

Purpose : To report a case of malignant oligodendroglioma with drop metastasis to spinal cord. We report the treatment result of this case. Case report : This 49 years old male patient is a case of left temporal oligodendroglioma, high grade. He received brain tumor excision and post -operative radiotherapy in 1999. Unfortunately, regional recurrence was found at vermis and cervicomedullar region in 2002. Then he received a course of intraarterial chemotherapy for brain recurrence. At the same time, low back pain with left sciatica was found for 10 months. Then spinal tumor was found and the tissue diagnosis was metastatic oligodendroglioma. Adjuvant radiation therapy to the L2-S3 region was given for 55 Gy/51 fraction 41 days from January, 2003. Result : After completion of radiotherapy, the symptom of low back pain had great improvement. At least 7 months up to recent follow up., this lesion did not show any obvious progression. Conclusion : There were only 8 cases of intracranial oligodendroglioma with spinal cord drop metastasis reported since 1942 to 2002. Base on this case, the compression symptom by tumor could be well controlled by radiation therapy.

並列關鍵字

oligodendroglioma ； spinal cord metastasis ； radiotherapy