담도암의 뇌수막 전이 1예
A Case of Cholangiocarcinoma with Brain and Leptomeningeal Carcinomatosis
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초록
증례의 환자는 담도암 진단 뒤 근치적 치료를 위해 수술을 하였으며 추적관찰 기간 동안 잔존간내 재발과 폐전이가발견되어 국소적 고주파 전기 소작술과 함께 전신적 항암약물 치료를 시행하였다. 수술 11개월 뒤 환자는 갑작스러운두통과 어지러움을 호소하였고 뇌 자기공명영상 촬영상 대뇌 좌측 후두부에서 약 5 cm의 낭성종양이 발견되어 뇌척수액(CSF) 세포병리검사결과 전이성 암으로 진단되었다. 환자는 Ommaya reservoir을 이용한 뇌척수액 배액술과 전뇌 방사선치료를 받은 뒤 호전 소견을 보였으나 간부전이 발생하여사망한 경우로 국내에서 담도암 뇌 내 낭성 병변으로 전이한 드문 증례를 경험하였기에 이를 문헌고찰과 함께 보고하는 바이다.
Abstract
Cholangiocarcinoma is a malignant disease originating from the epithelium of the biliary tract, and its prognosis is dismal due to distant metastasis in its early stages. The most common metastatic sites are the intra-abdominal organs, lymph nodes, and lungs. A patient was diagnosed with intrahepatic cholangiocarcinoma and underwent surgical resection. During the follow-up period,metastases were detected at the remnant liver and both lung fields. Eleven months after resection, the patient complained of severe headache. An approximately 5-cm cystic mass was found at the left occipital lobe of the cerebrum, and metastatic malignant cells were present on cerebrospinal fluid cytology. The patient underwent whole-brain radiotherapy. We herein report a rare case of cholangiocarcinoma with cystic brain metastasis together with a review of the relevant literature. (Korean J Med 2012;83:771-774)
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