背景:平滑肌肉瘤(LMS)是一种罕见的肿瘤,起源于胚胎中胚层起源的组织。起源的主要组织可以包括腹骨盆内脏的平滑肌细胞,血管,或者诱导菌毛肌肉。已知LMS会转移到肺部,很少报道传播到中枢神经系统的病例。
方法:一名66岁男性,患有左前臂皮肤LMS,肺部和肾脏转移,接受放化疗治疗,头痛恶化。磁共振成像显示鞍区病变。内分泌检查并不明显。超过6个月的成像显示间隔快速增长。正电子发射断层扫描显示中等吸收。鉴于快速增长,患者接受了内镜经鼻入路切除.病理证实LMS。
结论:据作者所知,这是第一例LMS转移到蝶鞍的病例.垂体癌或转移到鞍区的患者之间应该有差异,鞍区肿瘤的生长速度快,骨侵蚀,或上颈部淋巴结或软组织病变的发现。显示显著间期生长的肿瘤应引起非腺瘤性病变的怀疑,即使没有内分泌功能障碍或颅神经病变,也应考虑手术干预。https://thejns.org/doi/10.3171/CASE2435。
BACKGROUND: Leiomyosarcoma (LMS) is a rare neoplasm that arises from tissues of embryonic mesodermal origin. Primary tissues of origin can include smooth muscle cells of the abdominopelvic viscera, blood vessels, or arrector pili muscles. LMS is known to metastasize to the lungs, with few reported cases of spread to the central nervous system.
METHODS: A 66-year-old male with cutaneous LMS of the left forearm with metastases to the lungs and kidney that had been treated with chemoradiation presented with worsening headaches. Magnetic resonance imaging revealed a sellar lesion. An endocrine workup was unremarkable. Imaging over 6 months revealed rapid interval growth. Positron emission tomography demonstrated moderate uptake. Given the rapid growth, the patient was offered an endoscopic endonasal approach for resection. Pathology confirmed LMS.
CONCLUSIONS: To the authors\' knowledge, this is the first documented
case of LMS metastasis to the sella. Pituitary carcinoma or metastases to the sellar region should be in the differential among patients with sellar region tumors with a rapid growth rate, bony erosion, or findings of lesions in the upper cervical lymph nodes or soft tissue. Tumors that show significant interval growth should raise suspicion for nonadenomatous lesions, and surgical intervention should be considered even in the absence of endocrinological dysfunction or cranial neuropathies. https://thejns.org/doi/10.3171/CASE2435.