[Cerebral metastasis from malignant thymoma]

Thymoma with extrathoracic metastasis is very rare, especially to the central nervous system. As far as we know, this is the 15th reported case of cerebral metastasis from malignant thymoma. The prognosis is very poor and almost all of them die in one to one and half years. We have experienced such a case, who is 56 years old man, presenting Gerstmann's syndrome and right-hemiparesis 8 months later after thoracotomy for removal of thymoma. At the admission time in this hospital, CT findings proved the tumor in the left temporoparietal area, left ventricle deformity and slight midline shift to right side. The average of CT density in the low density area was 20. Peripheral region of the tumor was enhanced by contrast CT. Left carotid angiography showed the ACA shift to the right side and abnormal vascularity of peripheral branches of angular artery (arterial phase) and also tumor strain in late artery (arterial phase) and also tumor strain in late arterial phase. Brain scintigram revealed accumulation in the left parietal region. The rt-hemiparesis was rapidly going to be rt-hemiplegia. Therefore, we have performed needle puncture to prevent rt-hemiplegia at the first time. In the course of needle puncture, 90 ml of dark and red fluid was gained at 3.0 cm depth from the cerebral surface. Immediately, the above two symptoms have improved remarkably. Post operative CT showed the reduction of tumor and improvement of the midline shift. The radical operation have been done 2 days after the needle puncture. The tumor was elastic-soft and hemorrhagic and appeared dark-red.(ABSTRACT TRUNCATED AT 250 WORDS)