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Distant metastasis of hepatocellular carcinoma to meckel’s cave and cranial nerves:A case report and review of literature

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World Journal of Hepatology 2021年第6期13卷 709-716页

作者： soo Ki Kim Takako Fujii Ryouhei Komaki Hisato Kobayashi Toyokazu Okuda Yumi Fujii Takanobu Hayakumo Kanako Yuasa Masahiro Takami Aya Ohtani Yuka saijo Yu-Ichiro Koma soo Ryang Kim Department of Gastroenterology Kobe Asahi HospitalKobe 653-0801HyogoJapan Division of Neurology Kobe University Graduate School of MedicineKobe 650-0017HyogoJapan Department of Radiology Kobe Asahi HospitalKobe 653-0801HyogoJapan Department of Pharmacy Kobe Asahi HospitalKobe 653-0801HyogoJapan Department of Pathology Kobe University Graduate School of MedicineKobe 650-0017HyogoJapan

BACKGROUND Metastasis occurs as a late event in the natural history of hepatocellular carcinoma(HCC),and most patients die of liver failure attributed to the tumor supplanting the ***,the brain is a less common metastatic *** sUMMARY We describe a rare case of hepatitis C virus-related multiple HCC metastasizing to the cavernous sinus,meckel’s cave,and the petrous bone involving multiple cranial nerves in an 82-year-old *** admission imaging studies including Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging(MRI)revealed multiple HCC nodules in both right and left *** guided biopsy of the left lobe revealed moderately differentiated *** targeted therapy with Lenvatinib(8 mg/d for 94 d,per os)and Ramucirumab(340 mg/d and 320 mg/d,two times by intravenous injection)were administered for 4 mo,resulting in progression of the *** months after the start of molecular target therapy,the patient presented with symptoms of hyperalgesia of the right face and limited abduction of the right eye,indicating disturbances in the right trigeminal and abducens *** MRI disclosed a mass involving the cavernous sinus,meckel’s cave and the petrous ***-enhanced MRI with gadolinium-chelated contrast medium revealed a well-defined mass with abnormal enhancement around the right cavernous sinus and the right meckel’s *** The diagnosis of metastatic HCC to the cavernous sinus,meckel’s cave,and the petrous bone was made based on neurological findings and imaging studies including MRI,but not on histological *** studies may provide insights into various methods for diagnosing HCC metastasizing to the craniospinal area.

关键词： meckel’s cave Abducens nerve Trigeminal nerve Hepatocellular carcinoma Magnetic resonance imaging Case report

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Nasal cavity-maxillary sinus-pterygopalatine fossa-meckel’s cave:a preliminary anatomic study of an endoscopy-based operative approach

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Neuroscience Bulletin 2009年第6期25卷 376-382页

作者：白志强蔡恩源王时强李照建王守彪青岛大学医学院附属医院神经外科一病区青岛266003 青岛大学医学院解剖学教研室青岛266071

Objective To provide a new approach for the treatment of tumor in meckel’s cave, by dissecting adjacent structures of the nasal cavity-maxillary sinus-pterygopalatine fossa-meckel’s cave approach. Methods Fifteen adult cadaver heads （30 sides） were dissected and the correlated anatomic landmarks were observed, measured and analyzed in an operative route. Results The approach was divided into 3 steps： entering the maxillary sinus, the later pterygopalatine fossa and the final meckel’s cave. safe access to meckel’s cave could be achieved by tracing the vidian neurovascular bundles and dissecting the quadrangular space （Qs）. The distances from the nasal columella to the apertura maxillaries, the sphenopalatine foramen, and the anterior foramen of the pterygoid canal were （44.08±2.61） mm, （64.83±2.42） mm, and （70.43±2.94） mm, respectively. The angles between the horizontal plate of the palatine bone and the link from nasal columella to apertura maxillaries, between the horizontal plate of the palatine bone and the link from nasal columella to sphenopalatine foramen were （38.10±2.46）° and （26.15±2.26）°, respectively. Conclusion The endoscopic approach of transnasal maxillary sinus-pterygopalatine fossa-meckel’s cave （ENMPA） is a safe and direct way to access meckel＇s cave, and could be employed for the treatment of tumor in meckel’s cave.

关键词： endoscope maxillary sinus meckel’s cave neuroanatomy

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美克氏腔(meckel's cave)内肿瘤

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南方医科大学学报 1982年第2期 167-170页

作者：李少卿第一军医大学第一附属医院脑外科

美克氏腔藏有三叉神经半月节及其神经根。发生在这个腔内的肿瘤有脑膜瘤、神经纤维瘤、胆脂瘤、胶质瘤、神经节细胞瘤、血管瘤等,前三者较为常见。

关键词：克氏半月节神经根硬脑膜外 meckel’s cave

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