颅内神经内分泌癌6例报道及文献复习
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摘要
目的探讨颅内神经内分泌癌的临床表现、影像学特征、病理学表现、治疗方法及其效果。方法回顾性分析2000～2018年收治的6例颅内神经内分泌癌的临床资料。结果肿瘤位于左侧顶枕叶及第四脑室内1例、右侧顶叶1例、右侧额叶3例、小脑半球1例。4例发现肺部占位。术前均误诊为胶质瘤。6例均手术全切肿瘤,术后病检结果示神经内分泌癌。5例术后随访1周至12个月,1例术后未行放、化疗,3个月死亡;4例术后伽玛刀治,1例6个月死亡,3例随访12个月生活基本自理。1例失访。结论颅内神经内分泌癌是一种极其罕见的疾病,恶性程度高,临床表现和影像学特征不明显,术前诊断较为困难,病理学是诊断的金标准,主要以手术切除为主辅以放、化疗的综合治疗。
Objective To investigate the clinical manifestations, imaging features and pathological features of intracranial neuroendocrine carcinoma in order to improve the diagnosis and treatment of this disease. Methods The clinical data of 6 patients(age,23～65 years; gender, 4 males and 2 females) with intracranial neuroendocrine carcinomas who were treated in our hospital from 2000 to2018 were retrospectively analyzed. Of 6 carinomas, 1 was in the left parietal occipital lobe and the fourth ventricle, 1 in the right parietal lobe, 3 in the right frontal lobe and 1 in the cerebellar hemisphere. The space-occupying lesions were found also in the lungs of4 patients. The surgical resection of the carinomas was performed on all the patients. The carcinomas were preoperatively misdiagnosed as gliomas in all the patients. All the neuroendocrine carcinomas were definitely made by pathological examination. Results Five patients were followed up from 1 week to 12 months after the surgery. One patient with metastatic tumor undergoing postoperative gamma knife treatment died 6 months after the surgery. One patient who did not receive further postoperative radiotherapy and chemotherapy died 3 months after the surgery. Three patients receiving the postoperative gamma knife therapy still survived 12 months after the surgery. One patient lost to be followed up. Conclusions The intracranial neuroendocrine carcinoma is a rare, and highly malignant tumor and the primary intracranial neuroendocrine carcinoma is more rare. Its diagnosis is difficult according to its clinical manifestations and imaging features. The histopathological manifestations are the gold standard of its diagnosis. The surgery and postoperative radiochemotherapy is a main method to treat the carcinoma.
Objective To investigate the clinical manifestations, imaging features and pathological features of intracranial neuroendocrine carcinoma in order to improve the diagnosis and treatment of this disease. Methods The clinical data of 6 patients(age,23～65 years; gender, 4 males and 2 females) with intracranial neuroendocrine carcinomas who were treated in our hospital from 2000 to2018 were retrospectively analyzed. Of 6 carinomas, 1 was in the left parietal occipital lobe and the fourth ventricle, 1 in the right parietal lobe, 3 in the right frontal lobe and 1 in the cerebellar hemisphere. The space-occupying lesions were found also in the lungs of4 patients. The surgical resection of the carinomas was performed on all the patients. The carcinomas were preoperatively misdiagnosed as gliomas in all the patients. All the neuroendocrine carcinomas were definitely made by pathological examination. Results Five patients were followed up from 1 week to 12 months after the surgery. One patient with metastatic tumor undergoing postoperative gamma knife treatment died 6 months after the surgery. One patient who did not receive further postoperative radiotherapy and chemotherapy died 3 months after the surgery. Three patients receiving the postoperative gamma knife therapy still survived 12 months after the surgery. One patient lost to be followed up. Conclusions The intracranial neuroendocrine carcinoma is a rare, and highly malignant tumor and the primary intracranial neuroendocrine carcinoma is more rare. Its diagnosis is difficult according to its clinical manifestations and imaging features. The histopathological manifestations are the gold standard of its diagnosis. The surgery and postoperative radiochemotherapy is a main method to treat the carcinoma.
引文
[1]Faggianno A,Mansueto G,Ferolla P,et al.Diagnosis and prognostic implication of the world hesalth organization classification of neu-roendoerinet tumors[J].J Endocrinol Invest,2008,31(3):216-223.
[2]Matula C,Roessler K,Burian M,et al.Primary Neuroendocrine(Merkel Cell)carcinoma of the anterior skull base[J].Skull Base Surg,1997,7(3):151-158.
[3]Hood B,Bray E,Bregy A,et al.Primary carcinoid tumor of the cavernous sinus[J].World Neurosurg,2014,81(1):209-213.
[4]Nakaguchi H,Matsuno A,Miyawaki S,et al.Small cell carcinoma originating from the cavernous sinus[J].Acta Neurochir(Wien),2010,152(3):493-500.
[5]Khagi S,Saif MV.Neuroendocrine tumors,treatment updates[J].J Pancreas,2013,14(4):367-371.
[6]Ragab Shalaby AM,Kazuei H,Koichi H,et al.Assessment of intracranial metastases from neuroendocrine tumors/carcinoma[J].J Neurosci Rural Pract,2016,7(3):435-439.
[7]Nakaguchi H,Matsuno A,Miyawaki S,et al.Small cell carcinoma originating from the cavernous sinus[J].Acta Neurochir(Wien),2010,152(3):493-500.
[8]Porter DG,Chakrabarty A,McEvoy A,et al.Intracranial carcinoid without evidence of extracranial disease[J].Neuropathol Appl Neurobiol,2000,26(3):298-300.
[9]李旭,高芳友,蒋伟峰.小脑半球囊实性神经内分泌癌1例报告并文献复习[J].贵州医药,2013,37(12):1130-1132.
[10]Boedeker CC,Neumann HP,Ridder GJ,et al.Paragangliomasin patients with mutations of the SDHD gene[J].Otolaryngol Head Neck Surg,2005,132(3):467-470.
[11]Cao J,Xu W,Du Z,et al.Pathologic progression,possible origin,and management of multiple primary intracranial neuroendocrine carcinomas[J].World Neurosurg,2017,106:13-17.
[12]Lach B,Joshi SS,Murty N,et al.Transformation of Merkel cell carcinomto ganglioneuroblastoma in intracranial metastasis[J].Hum Pathol,2014,45(9):1978-1981.
[13]Sopranzi A,Santucci N,Bolognini A,et al.Neuroendocrine carcinoma of the colon with metastasis to the brain:a case report and review of the literature[J].Chir Ital,2005,2(1):115-120.
[14]Franco P1,Numico G,Migliaccio F,et al.Head and neck region consolidation radiotherapy and prophylactic cranial irradiation with hippocampal avoidance delivered with helical tomotherapy after induction chemotherapy for nonsinonasal neuroendocrine carcinoma of the upper airways[J].Radiat Oncol,2012,15:7-21.
[15]Akimoto J,Fukuhara H,Suda T,et al.Clinicopathological analysis in patients with neuroendocrine tumors that metastasized to the brain[J].BMC Cancer,2016,22:16-36.
[16]D'Antonio C,Passaro A,Gori B,et al.Bone and brain metastasis in lung cancer:Recent advances in therapeutic strategies[J].Ther Adv Med Oncol,2014,6:101-104.2018-10-182018-12-11
[2]Matula C,Roessler K,Burian M,et al.Primary Neuroendocrine(Merkel Cell)carcinoma of the anterior skull base[J].Skull Base Surg,1997,7(3):151-158.
[3]Hood B,Bray E,Bregy A,et al.Primary carcinoid tumor of the cavernous sinus[J].World Neurosurg,2014,81(1):209-213.
[4]Nakaguchi H,Matsuno A,Miyawaki S,et al.Small cell carcinoma originating from the cavernous sinus[J].Acta Neurochir(Wien),2010,152(3):493-500.
[5]Khagi S,Saif MV.Neuroendocrine tumors,treatment updates[J].J Pancreas,2013,14(4):367-371.
[6]Ragab Shalaby AM,Kazuei H,Koichi H,et al.Assessment of intracranial metastases from neuroendocrine tumors/carcinoma[J].J Neurosci Rural Pract,2016,7(3):435-439.
[7]Nakaguchi H,Matsuno A,Miyawaki S,et al.Small cell carcinoma originating from the cavernous sinus[J].Acta Neurochir(Wien),2010,152(3):493-500.
[8]Porter DG,Chakrabarty A,McEvoy A,et al.Intracranial carcinoid without evidence of extracranial disease[J].Neuropathol Appl Neurobiol,2000,26(3):298-300.
[9]李旭,高芳友,蒋伟峰.小脑半球囊实性神经内分泌癌1例报告并文献复习[J].贵州医药,2013,37(12):1130-1132.
[10]Boedeker CC,Neumann HP,Ridder GJ,et al.Paragangliomasin patients with mutations of the SDHD gene[J].Otolaryngol Head Neck Surg,2005,132(3):467-470.
[11]Cao J,Xu W,Du Z,et al.Pathologic progression,possible origin,and management of multiple primary intracranial neuroendocrine carcinomas[J].World Neurosurg,2017,106:13-17.
[12]Lach B,Joshi SS,Murty N,et al.Transformation of Merkel cell carcinomto ganglioneuroblastoma in intracranial metastasis[J].Hum Pathol,2014,45(9):1978-1981.
[13]Sopranzi A,Santucci N,Bolognini A,et al.Neuroendocrine carcinoma of the colon with metastasis to the brain:a case report and review of the literature[J].Chir Ital,2005,2(1):115-120.
[14]Franco P1,Numico G,Migliaccio F,et al.Head and neck region consolidation radiotherapy and prophylactic cranial irradiation with hippocampal avoidance delivered with helical tomotherapy after induction chemotherapy for nonsinonasal neuroendocrine carcinoma of the upper airways[J].Radiat Oncol,2012,15:7-21.
[15]Akimoto J,Fukuhara H,Suda T,et al.Clinicopathological analysis in patients with neuroendocrine tumors that metastasized to the brain[J].BMC Cancer,2016,22:16-36.
[16]D'Antonio C,Passaro A,Gori B,et al.Bone and brain metastasis in lung cancer:Recent advances in therapeutic strategies[J].Ther Adv Med Oncol,2014,6:101-104.2018-10-182018-12-11
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