Cerebellopontine angle metastasis of a neuroendocrine tumor mimicking vestibular schwannoma: A case report.
Cerebellopontine angle metastasis of a neuroendocrine tumor mimicking vestibular schwannoma: A case report.
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DOI：
10.25259/sni_117_2022
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发表时间：
2022
影响因子：
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通讯作者：
Kishima, Haruhiko
中科院分区：
文献类型：
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作者：
Yamada, Shuhei;Kijima, Noriyuki;Kinoshita, Manabu;Shinzaki, Shinichiro;Sato, Kazuaki;Kido, Kansuke;Hirayama, Ryuichi;Kagawa, Naoki;Takehara, Tetsuo;Morii, Eiichi;Kishima, Haruhiko
神经内分泌肿瘤（NETs）是由神经内分泌细胞产生的罕见肿瘤，很少与颅内转移有关。我们讨论的情况下，一个74岁的妇女与右侧CPA肿瘤。她有腹膜后NET病史，但由于右侧听力丧失和右侧CPA肿瘤沿着VII和VIII神经被诊断为前庭神经鞘瘤。经过3年的随访，她出现了反复呕吐，1个月的步态不稳史和3个月的全身疲劳史。脑成像显示肿瘤生长和右侧小脑水肿变化。她接受了乙状窦后开颅术和部分切除术。组织学检查显示转移性NET。她接受了立体定向放射外科治疗残留病变，在11个月的随访中，磁共振成像（MRI）证实病变缩小。这是第一个病例报告的自然过程中小脑脑桥转移的NET。CPA肿瘤的鉴别诊断是多种多样的，在我们的病例中，由于典型的症状和影像学特征，我们怀疑是前庭神经鞘瘤。然而，肿瘤生长相对快于预期，并显示在3年的随访肿瘤内出血。因此，对于有NET病史的患者，即使是MRI高度怀疑为另一种良性肿瘤的病变，也建议进行仔细的随访。仔细的随访影像学和适当的治疗策略是有用的管理脑转移瘤。虽然NET转移到CPA是非常罕见的，这种可能性应考虑当NET患者有颅内病变。
Neuroendocrine tumors (NETs) are uncommon neoplasms arising from neuroendocrine cells and are rarely associated with intracranial metastases. We discuss the case of a 74-year-old woman with a right CPA tumor. She had a history of retroperitoneal NET, but was diagnosed with vestibular schwannoma due to a right-sided hearing loss and a right CPA tumor along the VII and VIII nerves. After a 3-year follow-up, she presented with repetitive vomiting, a 1-month history of gait instability, and a 3-month history of general fatigue. Brain imaging revealed tumor growth and edematous changes in the right cerebellum. She underwent retrosigmoid craniotomy and partial resection. Histopathological examination revealed metastatic NET. She underwent stereotactic radiosurgery for residual lesion and, at 11 months of follow-up, the lesion was confirmed to have shrunk on magnetic resonance imaging (MRI). This is the first case to report the natural course of cerebellopontine metastasis of a NET. The differential diagnosis of CPA tumors is diverse, and, in our case, we suspected a vestibular schwannoma because of the typical symptoms and imaging features. However, the tumor grew relatively faster than expected and showed intratumoral hemorrhage during the 3-year follow-up. Therefore, in patients with a history of a NET, a careful follow-up is advisable even for lesions highly suspected to be another benign tumor on MRI. Careful follow-up imaging and appropriate treatment strategies were useful to manage the brain metastasis. Although NETs metastasizing to the CPA are extremely rare, this possibility should be considered when patients with NETs have intracranial lesions.