原发性子宫颈癌轻脑膜转移一例及文献复习

IF 0.3 Q4 ONCOLOGY
A. Kahvecioglu, S. Yuce Sari, H. Yıldırım, Z. Arık, M. Gultekin, F. Yıldız
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引用次数: 0

摘要

目标。原发性子宫颈癌的轻脑膜转移(LM)是罕见的,治疗方案有限。在本病例报告和文献回顾中,我们的目的是介绍一名宫颈癌LM患者,并讨论先前文献中报道的病例。案例演示。我们的病例是一名58岁的患者,最初被诊断为转移性原发性宫颈癌,并接受化疗和放化疗。随访期间,患者出现神经系统症状,并在颅脊髓区检测到LM。脑脊液细胞学检查证实转移性疾病。患者同时接受鞘内甲氨蝶呤和全脑放疗(WBRT)。获得了良好的临床和细胞学反应。然而,尽管在WBRT后继续使用鞘内甲氨蝶呤,但在放射学反应评估之前,她就死于血液学毒性。结论。在宫颈癌患者中,LM是一种极其罕见和灾难性的远处扩散模式。在文献中,截至目前共报道了26例患者。检测到LM后的中位生存期为9周,包括我们的病例。多模式联合治疗,如全身和鞘内化疗和放疗(RT)。然而,这些报告大多没有关于毒性的详细信息。尽管联合使用了积极的治疗方式,但患者的生存期有限,血液毒性的风险很高。应避免同时使用鞘内化疗和放疗,因为会增加发病率的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Leptomeningeal metastasis in primary uterine cervical cancer: a rare case and review of the literature
Objectives. Leptomeningeal metastasis (LM) of primary uterine cervical cancer is rare and treatment options are limited. In this case report and literature review, we aimed to present a patient with cervical cancer with LM and discuss previously reported cases in the literature. Case presentation. Our case was a 58-year-old patient who was initially diagnosed with metastatic primary uterine cervical cancer and treated with chemotherapy and chemoradiotherapy. During follow-up, she developed neurological symptoms, and LM was detected in the craniospinal regions. Cerebrospinal fluid cytology examination has confirmed metastatic disease. The patient was treated with concurrent intrathecal methotrexate and whole-brain radiotherapy (WBRT). A good clinical and cytological response was obtained. However, while intrathecal methotrexate was being continued after WBRT, she succumbed to hematological toxicity before the radiological response could be evaluated. Conclusions. LM is an extremely rare and catastrophic distant spread pattern in patients with cervical cancer. In the literature, a total of 26 patients were reported up to date. Median survival after detection of LM was nine weeks, including our case. Multimodal treatment combinations such as systemic and intrathecal chemotherapy and radiotherapy (RT) were used. However, most of these reports did not have detailed information about toxicity. Despite the combined use of aggressive treatment modalities, patients have limited survival and very high risks of hematologic toxicity. Concurrent use of intrathecal chemotherapy and radiotherapy should be avoided due to increased risk of morbidity.
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来源期刊
CiteScore
0.90
自引率
20.00%
发文量
46
审稿时长
15 weeks
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