背景:恶性嗜铬细胞瘤合并脑和颅骨转移是一种非常罕见的疾病。将我们的案例与以前报告的从PubMed搜索中确定的16个案例相结合,对17例恶性脑嗜铬细胞瘤进行了分析。这篇文献综述旨在提供有关临床表现的信息,放射学和组织病理学特征,以及这种情况的治疗策略。
方法:一名60岁男子因进行性头痛和头皮肿块增大而入院,持续3个月。X线图像显示左侧颞侧双凸形硬膜外肿块和多个溶解性病变。患者接受了左颞骨开颅手术切除颞骨肿瘤。组织病理学分析可将肿块鉴定为恶性嗜铬细胞瘤。患者的症状在术后3个月的临床随访中得到缓解。然而,在1年的临床随访计算机断层扫描中,在右侧第6肋骨和第6至第9胸椎上发现了转移性嗜铬细胞瘤病变。
结论:磁共振波谱和组织病理学检查对于恶性脑嗜铬细胞瘤和脑膜瘤的鉴别诊断是必要的。手术是治疗的首选。
BACKGROUND: Malignant pheochromocytoma with cerebral and skull metastasis is a very rare disease. Combining our
case with 16 previously reported cases identified from a PubMed search, an analysis of 17 cases of malignant cerebral pheochromocytoma was conducted. This literature review aimed to provide information on clinical manifestations, radiographic and histopathological features, and treatment strategies of this condition.
METHODS: A 60-year-old man was admitted with a progressive headache and enlarging scalp mass lasting for 3 mo. Radiographic images revealed a left temporal biconvex-shaped epidural mass and multiple lytic lesions. The patient underwent a left temporal craniotomy for resection of the temporal tumor. Histopathological analysis led to identification of the mass as malignant pheochromocytoma. The patient\'s symptoms were alleviated at the postoperative 3-mo clinical follow-up. However, metastatic pheochromocytoma lesions were found on the right 6th rib and the 6th to 9th thoracic vertebrae on a 1-year clinical follow-up computed tomography scan.
CONCLUSIONS: Magnetic resonance spectroscopy and histopathological examination are necessary to make an accurate differential diagnosis between malignant cerebral pheochromocytoma and meningioma. Surgery is regarded as the first choice of treatment.