https://scholars.lib.ntu.edu.tw/handle/123456789/506296
標題: | Leptomeningeal metastasis of poorly differentiated uterine cervical adenosquamous carcinoma following reirradiation to metastatic vertebrae | 作者: | Lu Y.-F. Fong V.H. Wu W.-Y. LI-YING WANG Hsieh C.-H. |
公開日期: | 2017 | 出版社: | Lippincott Williams and Wilkins | 卷: | 96 | 期: | 19 | 起(迄)頁: | e6894 | 來源出版物: | Medicine (United States) | 摘要: | Rationale: Leptomeningeal metastasis from cervical adenosquamous carcinoma is extremely rare especially after radiotherapy for vertebral metastasis. Patient concerns: A 52-year-old woman with International Federation of Gynecology and Obstetrics (FIGO) stage IIB adenosquamous carcinoma of cervix presented with bilateral lower limbs weakening after 2 courses radiotherapy to thoracic vertebral metastases. Diagnoses: Initial spine magnetic resonance imaging (MRI) showed no obvious nerve compression, and radiation myelopathy was suspected by the clinician. Progressive multifocal neurological signs developed one month after completion of spine re-irradiation. She was diagnosed with leptomeningeal metastasis by MRI and cerebrospinal fluid (CSF) study. Interventions: She received whole brain irradiation with a dose of 30 Gy in 10 fractions. Systemic chemotherapy with cisplatin (50mg/m 2) and topotecan (0.75mg/m 2) was administered sequentially. Outcomes: She died with progressive disease two months after the diagnosis of leptomeningeal metastases. Lessons: Poorly differentiated advanced-stage cervical adenosquamous carcinoma is an aggressive neoplasm with a worse outcome. Leptomeningeal metastasis should be included in the differential diagnosis for patients with multifocal craniospinal neurological signs. A combination of detailed neurological examinations, MRI and CSF study allowed us to establish a correct diagnosis of leptomeningeal metastasis and initiate treatment in a timely manner. Copyright ? 2017 the Author(s). |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85019473132&doi=10.1097%2fMD.0000000000006894&partnerID=40&md5=67d39c0b283f11a5c18720011bc35390 https://scholars.lib.ntu.edu.tw/handle/123456789/506296 |
ISSN: | 0025-7974 | DOI: | 10.1097/MD.0000000000006894 | SDG/關鍵字: | CA 125 antigen; carcinoembryonic antigen; cisplatin; glucose; lactate dehydrogenase; prednisolone; topotecan; adenosquamous carcinoma; adult; advanced cancer; Article; backache; blurred vision; brachytherapy; brain metastasis; cancer chemotherapy; cancer diagnosis; cancer radiotherapy; cancer staging; case report; cauda equina; cerebrospinal fluid; cerebrospinal fluid analysis; differential diagnosis; diplopia; disease duration; disseminated intravascular clotting; female; follow up; hearing impairment; histopathology; human; hypesthesia; leptomeningeal metastasis; lumbar puncture; middle aged; multimodality cancer therapy; muscle weakness; neurologic examination; nociception; nuclear magnetic resonance imaging; oculomotor nerve; outcome assessment; paraplegia; paresthesia; positron emission tomography-computed tomography; priority journal; ptosis; radiation dose; re-irradiation; septic shock; spinal cord disease; uterine cervix carcinoma; vagina bleeding; vertebra body; vestibulocochlear nerve; whole brain radiotherapy; Carcinoma, Adenosquamous; diagnostic imaging; fatality; Meningeal Neoplasms; pathology; re-irradiation; secondary; Spinal Neoplasms; thoracic vertebra; Uterine Cervical Neoplasms; Carcinoma, Adenosquamous; Fatal Outcome; Female; Humans; Meningeal Neoplasms; Middle Aged; Re-Irradiation; Spinal Neoplasms; Thoracic Vertebrae; Uterine Cervical Neoplasms |
顯示於: | 物理治療學系所 |
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