Recurrent metastatic hepatocellular carcinoma presenting as consecutive “mirror image” intracerebral haematomas
Recurrent metastatic hepatocellular carcinoma presenting as consecutive “mirror image” intracerebral haematomas
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复发性转移性肝细胞癌表现为连续的“镜像”脑内血肿
DOI：
10.1016/j.jocn.2004.08.026
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发表时间：
2005
影响因子：
2
通讯作者：
S. Paik
中科院分区：
文献类型：
--
作者：
D. Cho;H. Yi;Y. Ko;S. Oh;Seung;S. Paik
一名34岁男性，既往有肝细胞癌（HCC）病史，主诉头痛和视力障碍。神经影像学检查显示右侧枕叶血肿边缘增强，手术时发现原发恶性肿瘤转移。手术和随后的辅助治疗后五个月，他失明。在神经影像学检查中，发现左侧枕叶血肿。患者拒绝手术干预。肝细胞癌通常有一个积极的临床过程，因此，复发性脑转移是一个罕见的临床问题。双侧半球出血的“双像”转移是罕见的，尚未有报道。我们认为这些转移是由于通过动脉途径的显微接种而发生的，而通过静脉途径（如通过巴特森神经丛）扩散是不太可能的。
A 34-year old man with a past history of hepatocellular carcinoma (HCC) complained of headache and visual disturbance. Neuroimaging revealed a right occipital haematoma with rim enhancement and at operation, a metastasis from the primary malignancy was found. Five months after surgery and subsequent adjuvant therapy, he presented with blindness. On neuroimaging, a left occipital haematoma was seen. The patient refused surgical intervention. HCC usually has an aggressive clinical course; therefore, recurrent cerebral metastasis is an uncommon clinical problem. “Mirror-image” metastasis, with bleeding in both hemispheres, is rare and has not been reported. We suggest that these metastases occur due to microscopic seeding via an arterial route, and that spread via a venous route, such as occurs through Batson’s plexus, is unlikely.