Supratentorial extraventricular anaplastic ependymoma with extracranial metastasis.
Supratentorial extraventricular anaplastic ependymoma with extracranial metastasis.
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DOI：
10.1016/j.jocn.2014.09.006
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发表时间：
2015-03
影响因子：
2
通讯作者：
Yung, W. K. Alfred
中科院分区：
文献类型：
--
作者：
Pachella, Laura A.;Kamiya-Matsuoka, Carlos;Lee, Eva Lu T.;Olar, Adriana;Yung, W. K. Alfred
室管膜瘤是一种相对罕见的恶性肿瘤，占所有成人原发性中枢神经系统肿瘤的2.0%。颅外转移是脑胶质瘤，尤其是间变性室管膜瘤非常罕见的并发症。本文的目的是显示室管膜瘤可以转移到软组织和淋巴结，以及分享我们的方法来应对这一挑战。我们报告一位男性间变性室管膜瘤复发，并转移至颈部及淋巴结。转移性疾病的诊断是基于右颈部可触及的结节和弥漫性颈部淋巴结病的临床表现。病理检查显示为间变性室管膜瘤。全身氟脱氧葡萄糖正电子发射断层扫描显示转移性疾病在右侧乳突区与弥漫性摄取在颈部淋巴结。依托泊苷、顺铂、长春新碱和环磷酰胺的三个化疗周期后，获得了临床和放射学反应。本病例强调颅外软组织转移是复发性间变性室管膜瘤的一种非典型表现。其他报告的情况下，颅外转移性室管膜瘤的介绍进行了讨论。颅内疾病的可能转移途径进行了讨论。它还说明了颅外疾病如何通过全身化疗保持稳定。
Ependymoma is a relatively rare malignancy accounting for 2.0% of all primary central nervous system tumors in adults. Extracranial metastasis is a very uncommon complication of gliomas, especially of anaplastic ependymomas. The objective of this paper is to show that ependymomas can metastasize to soft tissue and lymph nodes as well as to share our approach to this challenge. We report a male patient with anaplastic ependymoma that recurred, metastasizing to the neck and lymph nodes. Metastatic disease was diagnosed based on clinical presentation of a palpable nodule on the right neck and diffuse cervical lymphadenopathies. A biopsy was obtained and pathology revealed anaplastic ependymoma. Whole-body fluorodeoxyglucose positron emission tomography scan showed metastatic disease in the right mastoid region with diffuse uptake in the cervical lymph nodes. Clinical and radiologic response was achieved after three chemotherapy cycles of etoposide, cisplatin, vincristine, and cyclophosphamide. This case highlights extracranial metastasis to the soft tissue as an atypical presentation of recurrent anaplastic ependymoma. Other reported instances of extracranial metastatic ependymoma of this presentation are discussed. The possible metastatic pathways of intracranial disease are discussed. It also illustrates how extracranial disease remains stable with systemic chemotherapy.
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