Brain Metastasis of Alveolar Soft Part Sarcoma treated Successfully with Hypothermia: A Case Report

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  • Sawauchi Satoshi
    Department of Neurosurgery, The Jikei University School of Medicine
  • Kabe Shigehiko
    Department of Neurosurgery, The Jikei University School of Medicine
  • Takahashi Kouichi
    Department of Neurosurgery, The Jikei University School of Medicine
  • Akiyama Masahiko
    Department of Neurosurgery, The Jikei University School of Medicine
  • Shukuya Ikuo
    Department of Neurosurgery, The Jikei University School of Medicine
  • Murakami Shigeyuki
    Department of Neurosurgery, The Jikei University School of Medicine
  • Ogawa Takeki
    Department of Neurosurgery, The Jikei University School of Medicine
  • Abe Toshiaki
    Department of Neurosurgery, The Jikei University School of Medicine

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  • 低体温療法により救命し得た alveolar soft part sarcoma の脳転移の1例

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We report on a patient with a brain metastasis from an alveolar soft part sarcoma of the leg who recovered after tumor removal followed by induction of hypothermia. A 29-year-old woman had undergone surgery to remove an alveolar soft part sarcoma of the left leg 3 years previously, and to remove a metastatic tumor of the lung 2 months prior to admission to our institution with a diagnosis of metastatic brain tumor. She was initially treated with stereotactic radiosurgery, but the day after radlosurgery became comatose due to aggravated edema of the brain. After administering barbiturate therapy, we totally extirpated the brain tumor. However, marked intracranial hypertension continued postoperatively, and we induced hypothermia to control the intracranial pressure. While the patient remained in a hypothermic state the intracranial pressure was well controlled and brain CT scans showed decreased edema. After rewarming, the patient was discharged without any neurological deficits except for visual acuity lost; in the left eye. Hypothermia is believed to protect against brain damage, and our results suggest that it is also effective in reducing the vasogenic edema associated with bi-ain tumors. Because alveolar soft part sarcomas grow slowly, surgery appears to be the treatment of choice.

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