罕见的RCCC脑室内转移1例报告并文献复习.pdfVIP

罕见的RCCC脑室内转移1例报告并文献复习 郭付有孙红卫宋来君 [摘要] 目的 总结罕见肾透明细胞癌(Renalclearcellcarcinoma,RCCC)脑室内转移的诊断及治疗要 点。方法 通过本例临床资料并结合文献对该病的临床特点、影像学特征及手术要点进行回顾性分析。结果 患者多系中老年；转移灶以单个孤立病灶为主；对放疗相对不敏感；头颅MRI主要表现为广泛瘤周水肿，瘤周 或瘤内流空效应及坏死囊变；术中出血汹涌，术后极易发生颅内血肿。结论 肾透明细胞癌脑室内转移临床 极其罕见，本例系国内首例报道，术中控制出血及术后预防血肿是手术成功的关键，临床预后差。 [关键词]脑室内转移瘤；肾透明细胞癌 Rarelateralventriclemetastasisfromrenalclearcellcarcinoma:casereportandlitera turereviewGUOFu-youHONGWei-sunSONGLai-junDepartmentofNeurosurgery,TheFirst AffiliatedHospitalofZhengzhouUniversity,Zhengzhou450052,China Abstract:Objective Tosummarytheclinicalcharacteristicsofrarelateralventriclemetastasis fromrenalclearcellcarcinoma(RCCC).Method Theclinicalmanifestations,imagingfeatures andoperationofRCCCwereanalyzedretrospectivelythroughpresentrarecase.Results Theclini calfeaturesrevealthattheintracranialmetastasesfromRCCCweresolitaryandmainlyinvolvedin theelderlypatientsaswellasrelativelyradioresistantcharacterisitic.Extensiveedemaandflowvoid surroundingmetastatictumorandnecrosiswereobservedonMRI.Surgerymaybedifficultbecause ofexcessivebleedingfromimmaturevesselsandpoorhemostasis,andpostoperativehematomais susceptibletooccurinRCCC.Conclusions ThelateralventriclemeatstasesfromRCCCisextreme lyrare,effectivebleedingcontrolandpreventionofpostoperativehematomaplayanimportantrolein successfuloperation,thelateralventriclemetastasesfromRCCCgenerallyhaspoorprognosis.To ourknowledge,thisisthefirstreportoflateralventriclemetastasisfromrenalclearcellcarcinomain Chinesepatients. Keywords: lateralventriclemetastasis;renalclearcellcarcinoma 郑州大学第一附属医院神经外科 Z测CDIO、CK召 为胞浆着色呈{ 明细胞癌脑室匹 】典型临床特征 IRI主要表现为 只水者；2：转移至后颅窝压迫脑干危2 剐达的部位者；4：患者既往体质良好j 扫于肾透明细胞癌脑室内转移瘤目前 ．术后形成颅内血肿的发生率将近50t 戈血肿‘纠，1987年Shigemori报告1例 004年Kadrian报告1例左侧脑室三 透明细胞癌脑室内转移瘤患者因术牛 例三脑室内透明细胞癌脑室内转移j 患者同样在手术中遇到了难以控制睁 ：低而暂时中止手术以减少出血，因此