1例小细胞肺癌囊性脑转移多学科诊疗分析

doi:10.11958/20251282

天津医药 ›› 2025, Vol. 53 ›› Issue (12): 1326-1329.doi: 10.11958/20251282

1例小细胞肺癌囊性脑转移多学科诊疗分析

于涛¹(), 汪俊萍², 张荣新³, 刘兵⁴, 徐东波⁵, 陈渊⁶, 钟殿胜¹^,^△()

¹ 天津医科大学总医院肿瘤内科（邮编300052）
² 天津医科大学总医院影像科
³ 天津医科大学总医院放疗科
⁴ 天津医科大学总医院神经外科
⁵ 天津医科大学总医院病理科
⁶ 天津医科大学总医院胸部肿瘤外科

收稿日期:2025-04-01 修回日期:2025-08-19 出版日期:2025-12-15 发布日期:2025-12-08
通讯作者: ^△E-mail：zhongdsh@hotmail.com E-mail:yutaogh@tmu.edu.cn;zhongdsh@hotmail.com
作者简介:于涛（1983），女，副主任医师，主要从事肺癌和消化道肿瘤的个体化精准诊疗研究。E-mail：yutaogh@tmu.edu.cn

Experience and clinical exploration by multidisciplinary diagnosis and treatment of cystic brain metastasis in a case of small cell lung cancer

YU Tao¹(), WANG Junping², ZHANG Rongxin³, LIU Bing⁴, XU Dongbo⁵, CHEN Yuan⁶, ZHONG Diansheng¹^,^△()

¹ Department of Oncology, Tianjin Medical University General Hospital, Tianjin 300052, China
² Department of Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
³ Department of Radiation, Tianjin Medical University General Hospital, Tianjin 300052, China
⁴ Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin 300052, China
⁵ Department of Pathology, Tianjin Medical University General Hospital, Tianjin 300052, China
⁶ Department of Thoracic Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China

Received:2025-04-01 Revised:2025-08-19 Published:2025-12-15 Online:2025-12-08
Contact: ^△E-mail：zhongdsh@hotmail.com E-mail:yutaogh@tmu.edu.cn;zhongdsh@hotmail.com

于涛, 汪俊萍, 张荣新, 刘兵, 徐东波, 陈渊, 钟殿胜. 1例小细胞肺癌囊性脑转移多学科诊疗分析[J]. 天津医药, 2025, 53(12): 1326-1329.

YU Tao, WANG Junping, ZHANG Rongxin, LIU Bing, XU Dongbo, CHEN Yuan, ZHONG Diansheng. Experience and clinical exploration by multidisciplinary diagnosis and treatment of cystic brain metastasis in a case of small cell lung cancer[J]. Tianjin Medical Journal, 2025, 53(12): 1326-1329.

摘要/Abstract

摘要：

随着磁共振成像等影像学技术的不断发展，脑转移瘤的检出率越来越高。其中囊性脑转移发病率虽然远低于实性脑转移，但囊性脑转移瘤患者病情急，占位效应明显，是临床亟待解决的问题。既往文献报道囊性脑转移多见于乳腺癌和肺腺癌，特别是驱动基因阳性肺癌患者。该文报告1例以神经系统症状起病的小细胞肺癌囊性脑转移患者在多学科诊疗模式下获得临床治愈，在影像学动态评估以及微小残留病灶检测下避免过度治疗，延长生存期的基础上获得较高的生活质量。

关键词: 小细胞肺癌, 囊性脑转移, 多学科诊疗, 分子残留病灶

Abstract:

With the continuous development of imaging techniques such as magnetic resonance imaging, the detection rate of brain metastases is increasing. Although the incidence rate of cystic brain metastasis is far lower than that of solid brain metastasis, patients with cystic brain metastasis are in urgent condition and have obvious space occupying effect, which is an urgent clinical problem. Previous literature has reported that cystic brain metastasis is more common in breast cancer and lung adenocarcinoma, especially in lung cancer patients with positive driver gene. This article reports a case of small cell lung cancer with cystic brain metastasis, which started with neurological symptoms, and was clinically cured under a multidisciplinary diagnosis and treatment model. Through dynamic imaging evaluation and molecular residual lesion detection, the patient can avoid overtreatment and achieved a relatively higher quality of life on the basis of prolonging survival.

Key words: small cell lung carcinoma, cystic brain metastases, multi-disciplinary treatment, molecular residual disease

中图分类号:

R734.2

图/表 4

图1 患者颅脑增强MRI和胸部CT影像 A：脑核磁冠状位；B：脑核磁矢状位；C：左肺上叶肿物；D：主肺动脉窗淋巴结。

Fig.1 Patient's contrast-enhanced brain MRI and chest CT scan

图2 患者脑转移瘤病理免疫组化染色（×40） A：TTF-1；B：CK；C：Syn；D：Ki-67。

Fig.2 Pathological immunohistochemical staining of patient's brain metastases (×40)

图3 患者抗肿瘤治疗动态CT评估 A：治疗基线（2021年12月）；B：化疗3周期后放疗前（2022年3月）；C：放化疗结束后（2022年8月）。

Fig.3 Dynamic CT assessment of patients' anti-tumor therapy

图4 患者肺部新发病灶动态CT复查评估 A：肺部新发病灶（2022年11月）；B：肺部新发病灶动态复查（2023年5月）；C：肺部新发病灶动态复查（2023年11月）。

Fig.4 Dynamically re-examined CT scan of the patient's new lung lesions

参考文献 7

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1例小细胞肺癌囊性脑转移多学科诊疗分析

Experience and clinical exploration by multidisciplinary diagnosis and treatment of cystic brain metastasis in a case of small cell lung cancer

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