鼻咽癌是国人头颈区域常见的恶性肿瘤之一,尽管鼻咽癌容易发生远处转移,包括骨骼、肺部、肝脏和远处淋巴结等部位,但继发于鼻咽癌的上矢状窦部位转移十分罕见。我们首次报道一例54岁鼻咽癌男性患者,该患者于放疗和化疗后24个月出现头痛、呕吐、癫痫发作,头颅MRI检查发现右侧额叶占位,肿瘤基底与矢状窦关系密切,临床初步诊断为窦旁脑膜瘤。患者接受了开颅手术治疗,术后组织学和免疫组化结果显示为鼻咽癌,术后随访6个月,患者未再出现局部或远处转移征象。尽管手术切除转移性鼻咽癌并不提倡,但对于部分继发鼻咽癌的颅内窦旁转移性病灶,手术切除仍具有一定的临床价值。
Nasopharyngeal carcinoma (NPC) is one of the most common malignancies in the head and neck,especially among Chinese population.Although NPC has a propensity to develop distant metastases at a high rate including bones,lungs,liver and distant lymph nodes,superior sagittal sinus metastases from NPC are very rare.We report a case of such a disease in a 54-year-old man with NPC who presented with heahache,vomiting and status epilepticus 24 months after finishing radiotherapy and chemotherapy.MRI showed the presence of a occupying lesion in right frontal lobe associated with superior sagittal sinus,which was initially misdiagnosed as a parasagittal meningioma.The patient received surgical treatment via craniotomy.Histologic and immunohistochemical analyses confirmed that it was original nasopharyngeal.After resection of the intracranial tumors,no signs of local or distant recurrence was noted during the 6 months follow up.Although surgical treatment plays a limited role in metastatic NPC,there is rare cases of intracranial sinus metastasis with a reasonable outcome after resections.
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