[A case of alveolar soft-part sarcoma with lung and cerebral metastasis (author's transl)]

A 37-year-old housewife who had episodes of surgical removal for an alveolar soft-part sarcoma of her right leg 15 years ago, and total removal for right lung metastasis 2 years ago, was admitted to our service with complaints of headache, vomiting, dyscalculia and recent memory disturbance which started about 4 months prior to admission. Neurological examination revealed papilledema and disorientation. Left carotid angiography and CT scan showed a ball-like vascular tumor in the left frontal lobe. Presumptive diagnosis of metastatic brain tumor in the left frontal lobe was made in our service. Left fronto-parietal craniotomy was carried out on Feb. 22, 1977 and total removal for the metastatic tumor were made. Specimens of the tumor showed typical feature of alveolar soft-part sarcoma histologically. Postoperative course was well and she was discharged without neurological deficits. Two years after the previous surgery for cerebral metastasis, another metastatic tumor was found in the left frontal lobe again. Total removal for this solitary metastatic tumor was performed again. Histological and electron microscopical examination was made with this tumor specimen. Typical feature of alveolar soft-part sarcoma was confirmed. She was discharged with a marked improvement of her symptoms. At present, it has been passed about a year after the second surgery on her, she is doing well without neurological deficits. Clinical features of alveolar soft-part sarcoma were discussed, especially with the comparison of clinical feature between the reported cases of Japan and the cases of foreign countries. Regarding the choice of the treatment of this tumor, total removal was seemed to be the best management. Therefore, all efforts should be focussed to discover in the earlier stage of this tumor.