Neurological Surgery 脳神経外科48巻8号

2020年08月発行

症例

分子病理診断で原発巣の特定に至った肺腺癌原発の粟粒性転移性脳腫瘍の1症例

著者： 永井利樹¹ 武内勇人¹ 鎌田一晃¹ 川邊拓也¹ 髙橋義信¹ 橋本直哉¹

所属機関： ¹京都府立医科大学大学院医学研究科脳神経機能再生外科学

ページ範囲：P.701 - P.706

Ⅰ．はじめに
　脳実質内に100個を超える粟粒性脳転移（miliary metastasis）で発症し，分子病理診断によって原発巣の同定に至り，遺伝子変異に基づいた治療を施行した症例を経験したので報告する．

参考文献

1) Bhushan C：“Miliary” metastatic tumors in the brain. Case report. J Neurosurg 86：564-566, 1997

2) Falk AT, Poudenx M, Otto J, Ghalloussi H, Barrière J：Adenocarcinoma of the lung with miliary brain and pulmonary metastases with echinoderm microtubule-associated protein like 4-anaplastic lymphoma kinase translocation treated with crizotinib：a case report. Lung Cancer 78：282-284, 2012

3) Hallberg B, Palmer RH：The role of the ALK receptor in cancer biology. Ann Oncol 27：Suppl 3：iii4-iii15, 2016

4) Hsu F, Nichol A, Toriumi T, De Caluwe A：Miliary metastases are associated with epidermal growth factor receptor mutations in non-small cell lung cancer：a population-based study. Acta Oncol 56：1175-1180, 2017

5) Inamura K, Takeuchi K, Togashi Y, Hatano S, Ninomiya H, Motoi N, Mun MY, Sakao Y, Okumura S, Nakagawa K, Soda M, Choi YL, Mano H, Ishikawa Y：EML4-ALK lung cancers are characterized by rare other mutations, a TTF-1 cell lineage, an acinar histology, and young onset. Mod Pathol 22：508-515, 2009

6) Karaca S, Karatas M, Yildirim T, Hurcan CE：Atypical MRI findings of synchronous cerebral metastasis. A case report and literature review. Neuroradiol J 22：72-77, 2009

7) Lee DH, Han JY, Kim HT, Yoon SJ, Pyo HR, Cho KH, Shin SH, Yoo H, Lee SH, Lee JS：Primary chemotherapy for newly diagnosed nonsmall cell lung cancer patients with synchronous brain metastases compared with whole-brain radiotherapy administered first：result of a randomized pilot study. Cancer 113：143-149, 2008

8) 日本臨床腫瘍学会：原発不明がん診療ガイドライン（改訂第2版）．南江堂，東京，2018, pp.18-24

9) Ogawa M, Kurahashi K, Ebina A, Kaimori M, Wakabayashi K：Miliary brain metastasis presenting with dementia：progression pattern of cancer metastases in the cerebral cortex. Neuropathology 27：390-395, 2007

10) Peters S, Camidge DR, Shaw AT, Gadgeel S, Ahn JS, Kim DW, Ou SI, Pérol M, Dziadziuszko R, Rosell R, Zeaiter A, Mitry E, Golding S, Balas B, Noe J, Morcos PN, Mok T；ALEX Trial Investigators：Alectinib versus crizotinib in untreated ALK-positive non-small-cell lung cancer. N Engl J Med 377：829-838, 2017

11) Polyzoidis KS, Miliaras G, Pavlidis N：Brain metastasis of unknown primary：a diagnostic and therapeutic dilemma. Cancer Treat Rev 31：247-255, 2005

12) Rivas E, Sanchez-Herrero J, Alonso M, Alvarez MJ, Teijeira S, Ballestín C, Tardio A, Navarro C：Miliary brain metastases presenting as rapidly progressive dementia. Neuropathology 25：153-158, 2005

13) Rodig SJ, Mino-Kenudson M, Dacic S, Yeap BY, Shaw A, Barletta JA, Stubbs H, Law K, Lindeman N, Mark E, Janne PA, Lynch T, Johnson BE, Iafrate AJ, Chirieac LR：Unique clinicopathologic features characterize ALK-rearranged lung adenocarcinoma in the western population. Clin Cancer Res 15：5216-5223, 2009

14) Shirai H, Imai S, Kajihara Y, Tamada T, Gyoten M, Kamei T, Hata T, Shirabe T：MRI in carcinomatous encephalitis. Neuroradiology 39：437-440, 1997

15) Yamamoto M, Serizawa T, Shuto T, Akabane A, Higuchi Y, Kawagishi J, Yamanaka K, Sato Y, Jokura H, Yomo S, Nagano O, Kenai H, Moriki A, Suzuki S, Kida Y, Iwai Y, Hayashi M, Onishi H, Gondo M, Sato M, Akimitsu T, Kubo K, Kikuchi Y, Shibasaki T, Goto T, Takanashi M, Mori Y, Takakura K, Saeki N, Kunieda E, Aoyama H, Momoshima S, Tsuchiya K：Stereotactic radiosurgery for patients with multiple brain metastases（JLGK0901）:a multi-institutional prospective observational study. Lancet Oncol 15：387-395, 2014