原发灶来源不明的脑转移瘤的临床特点及治疗  

Clinical features and treatment of brain metastasis in patients with malignant tumors of unknown primary

作　　者：穆林森[1] 张红波 陈谦学[3] 田道锋[3] 徐海涛[3] 李明昌[3] 熊晓星[3] 刘宝辉[3] 

机构地区：[1]广州市脑科医院神经外科,510370 [2]湖北省中西医结合医院神经外科,武汉430015 [3]武汉大学人民医院神经外科,武汉430060

出　　处：《中国临床神经外科杂志》2015年第12期733-735,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨原发灶来源不明的脑转移瘤（BMUP）的临床特点及治疗方法。方法回顾性分析26例BMUP患者的临床资料。结果病灶位于额叶8例、顶叶13例、枕叶1例、小脑3例、基底节区1例。19例单发转移灶全切除,7例多发灶者行症状侧病灶全切除术。术后均接受普通放疗,其中3例多发转移瘤加行替莫唑胺辅助化疗。术后随访6～78个月,平均28个月;复发7例（单发灶2例,多发灶5例）,再次手术治疗2例,化疗3例,2例因颅内播散、恶性颅内压增高死亡。结论 BMUP影像学及病理学具有一定特征,治疗主要采取以手术为主的综合治疗,术后常规放化治疗可延缓肿瘤生长,提高患者生存率。Objective To explore the clinical features and treatment of brain metastases from unknown primary malignant tumors. Method The clinical data of 26 patients with brain metastases from unknown primary malignant tumors were analyzed retrospectively, including their disease history, past history, clinical manifestations, laboratory examination, neuroimaging findings, treatment and pathology results and so on. Results Of 26 cases of brain metastases, 8 were in the frontal lobes, 13 in the parietal lobes, 1 in the occipital lobe, 3 in the cerebellums and 1 in the basal ganglia. The solitary metastases were totally resected in 19 patients and the symptomatic foci were resected in 7 patients with multiple metastases. The adjuvant chemotherapy with temozolomid was performed in 3 patients with multiple metastases. All the patients were followed up from 6 to 78 months （mean, 28 months）. Of 7 patients in whom the tumors recurred during the following-up, 5 had multiple metastases and 2 solitary metastases before the operation. Of 7 patients with recurrent tumors, 2 underwent surgery and 3 chemotherapy again and 2 died. Conclusions The brain metastases from the unknown primary tumors were clinically common. The brain metastases imaging and pathology are of certain characteristics. The postoperative conventional radiotherapy and chemotherapy are helpful to prolonging the survival time and improving the prognoses in the patients with brain metastases from unknown primary malignant tumors.

关 键 词：原发灶不明的脑转移瘤 临床特征 治疗 

分 类 号：R739.41[医药卫生—肿瘤] R651.11[医药卫生—临床医学]