Meningeal metastases
Introduction
Introduction to meningeal metastases Dura materoma refers to neuroblastoma, which is a common malignant tumor in children. It has a higher degree of malignancy and metastasis earlier, but intracranial metastasis is rare, especially in patients with dural metastasis. The case report is as follows: HS2 case report, male, 9 years old. The left eyeball progressively protruded for 20 days, which was independent of body position, normal vision, no headache and fever. CT showed the left lateral iliac crest, the sphenoid ridge, the right axilla, and the fusiform soft tissue mass below the inner skull of the right iliac crest. The density was uniform, the CT value was 51-55HU, the inner edge was smooth and the thin line dura was visible. Shallow lobes, enhanced lesions significantly enhanced 77-84HU, and thickened dura mater on the inner edge, the inner edge of the mass is clear, partially blurred, the mass is about 30cm × 30cm × 25cm - 10cm × 10cm × 07cm The inner skull has worm-like, osteolytic, brush-like bone destruction, and there is a small bone defect in the left frontal part. The lateral rectus muscle is under pressure and the bone penetration is confirmed as neuroblastoma. Nodular dural metastases are a rare type of malignant tumor with meningeal metastasis. Because it is different from typical meningeal metastasis, it only shows tumors connected to the dura mater on CT or MRI, lacking extensive meningeal enlargement. Thick, intensive background, easy to misdiagnose as a common brain tumor - meningioma. basic knowledge The proportion of illness: 0.002% Susceptible people: no special people Mode of infection: non-infectious Complications: lung cancer
Cause
Cause of meningeal metastases
Meningeal metastases are a serious lesion that directly invades the meninges by hematogenous metastasis, disseminated by cerebrospinal fluid to the meninges or adjacent tumors. Early correct diagnosis is beneficial to its related treatment and prognosis.
Prevention
Meningeal metastasis prevention
There is no effective preventive measure for this disease. Early detection and early diagnosis are the key to the prevention and treatment of this disease.
Complication
Meningeal metastases complications Complications
Hematogenous dissemination is the most common metastatic route of meningeal metastases, of which lung cancer is the most common.
Symptom
Symptoms of meningeal metastases Common symptoms Pain keratin thickening after nodular surgery
Most of the meningeal metastases are nodular or diffuse linear thickening. Dural-arachnoid type, characterized by nodular or thickened segmental linear lesions on the surface of the brain that are close to the inner surface of the skull and along the cerebral palsy and cerebellum, without deep sulci, cerebral cistern, continuous level Can be seen.
Examine
Examination of meningeal metastases
MR enhancement revealed metastatic nodules >3 cm in diameter and meningeal thickening >0.2 cm thick. It is best to carry out comparative analysis of CT and MRI at the same time to obtain a more accurate qualitative diagnosis. Various types of meningioma are rich in vascular structure, DSA and superselective angiography, confirming tumor vascular structure, tumor rich in blood vessels, major cerebral vascular displacement, and the relationship between tumor and large dural sinus At the same time, combined with other clinical organ examinations and related malignant tumor history and examination results, comprehensive judgment can be diagnosed.
Diagnosis
Diagnosis and differentiation of meningeal metastases
Differential diagnosis
Pia mater - arachnoid type, characterized by small nodular or thin-line lesions close to the surface of the brain, and can penetrate deep into the sulci and cerebral cistern, mainly in the pia mater, subarachnoid space, ependymal and ventricular wall, etc. The site is accompanied by an enlargement of the ventricles. According to the morphology of meningeal metastases, they are divided into three subtypes:
The linear thickening type is characterized by a diffuse thickening of the meninges and a linear shape.
Nodular type, meningeal metastases are round, nodular or lumpy.
In the mixed type, the above two different shapes of lesions exist simultaneously.
