WorldWideScience

Sample records for brain metastasis case

  1. BRAIN METASTASIS FROM HEPATOCELLULAR CARCINOMA: A RARE CASE

    Directory of Open Access Journals (Sweden)

    A. Kh. Bekyashev

    2012-01-01

    Full Text Available Hepatocellular carcinoma ranks 5th in prevalence and 3rd in cancer mortality worldwide. The prognosis of this disease is very poor: the 5-year survival rate was not more than 3–5%. Metastases generally occur in the lung, in the lymph nodes of the abdomen, chest, and neck, in the vertebrae, kidneys, and adrenals. The cases of brain metastasis from hepatocellular cancer are very rare. Overall, the prognosis is very poor for patients with brain metastases from hepatocellular carcinoma. Nevertheless, solitary brain metastases and good hepatic function are favorable survival criteria; thus, the treatment of this group of patients may lead to their better survival. The paper describes a clinical case of brain metastasis from hepatocellular carcinoma in a patient receiving the combination treatment involving neurosurgical treatment and targeted therapy. 

  2. Solitary hemorrhagic brain metastasis from pulmonary blastoma: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hak Soo; Lee, Seung Ro; Bae, Oh Keun; Park, Doung Woo; Choi, Yo Won; Jeon, Seok Chol; Park, Choong Ki; Hahm, Chang Kok; Lee, Jung Dal [Hanyang Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-02-01

    Pulmonary blastoma is a rare primary lung malignancy consisting of mesenchymal and epithelial components resembling the fetal lung. We report a case of pulmonary blastoma with solitary hemorrhagic brain metastasis in a 32-year-old man. This metastatic lesion was composed mainly of hemorrhagic high density and central necrotic low density areas; on CT it showed partial contrast enhancement and was thus impossible to distinguish from other hemorrhagic lesions.

  3. Solitary hemorrhagic brain metastasis from pulmonary blastoma: a case report

    International Nuclear Information System (INIS)

    Pulmonary blastoma is a rare primary lung malignancy consisting of mesenchymal and epithelial components resembling the fetal lung. We report a case of pulmonary blastoma with solitary hemorrhagic brain metastasis in a 32-year-old man. This metastatic lesion was composed mainly of hemorrhagic high density and central necrotic low density areas; on CT it showed partial contrast enhancement and was thus impossible to distinguish from other hemorrhagic lesions

  4. Brain metastasis from uterine serous carcinoma: A case report and review of literature

    OpenAIRE

    Tania Sierra; Long Nguyen; Justin Mascitelli; Tamara Kalir; David Fishman

    2015-01-01

    Highlights • Brain metastasis from UPSC is rare, with 9 cases in the literature. • UPSC may resemble other endometrial cancers in regard to brain metastatic behavior. • When appropriate, it seems that multimodal therapy offers the best outcomes.

  5. Brain metastasis from uterine serous carcinoma: A case report and review of literature.

    Science.gov (United States)

    Sierra, Tania; Nguyen, Long; Mascitelli, Justin; Kalir, Tamara; Fishman, David

    2015-01-01

    Brain metastasis from UPSC is rare, with 9 cases in the literature.•UPSC may resemble other endometrial cancers in regard to brain metastatic behavior.•When appropriate, it seems that multimodal therapy offers the best outcomes. PMID:26076093

  6. Miliary brain metastasis presenting with calcification in a patient with lung cancer: a case report

    Directory of Open Access Journals (Sweden)

    Inomata Minehiko

    2012-09-01

    Full Text Available Abstract Introduction Miliary brain metastasis is an extremely rare form of brain metastasis which can present with atypical imaging findings. We report the case of a patient with miliary brain metastasis of lung cancer showing calcification in metastatic lesions. Case presentation A 68-year-old Japanese woman was diagnosed with lung adenocarcinoma. Brain computed tomography revealed multiple small calcified lesions in both cerebral hemispheres. Mutation of the epidermal growth factor receptor gene (exon 21, L858R in lung cancer cells was detected, and treatment with gefitinib was initiated. A partial response was observed; however, the patient was readmitted to our hospital because of regrowth of the primary lesion and complaints of nausea, headache, and difficulty walking. Brain magnetic resonance imaging revealed scattered tiny nodules enhanced by gadolinium. A diagnosis of leptomeningeal carcinomatosis was made on the basis of cerebrospinal fluid cytology. The patient’s general status worsened, and she died 356 days after the day of first medical examination. Upon autopsy, the brain was found to be edematous and swollen. Lung carcinoma cells were diffusely disseminated on the meningeal surface. Metastatic foci of small nodular form, accompanied by calcifications, were also found in the brain parenchyma. We diagnosed miliary metastasis of lung carcinoma. Conclusions To the best of our knowledge, this is the third report of calcified miliary brain metastasis confirmed by autopsy. We describe calcified lesions that increased in size during the clinical course of nine months. Brain computed tomography findings that reveal multiple small calcified lesions in patients with malignancy should raise suspicion of miliary brain metastasis.

  7. A case of leukoencephalopathy caused by radiation and chemotherapy for brain metastasis of breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Shigeru; Sonoo, Hiroshi; Nomura, Tsunehisa; Ohkubo, Sumiko; Yamamoto, Yutaka; Tanaka, Katsuhiro; Kurebayashi, Junichi; Hiratsuka, Junichi [Kawasaki Medical School, Kurashiki, Okayama (Japan)

    2002-08-01

    A case of treatment-related leukoencephalopathy is presented. A patient with breast cancer metastasis to the brain, liver, bone and distant lymph nodes was treated with whole brain radiation and docetaxcel. Eleven months after radiation, magnetic resonance imaging showed diffuse leukoencephalopathy. Twenty-two months after radiation, the patient had gait disturbance, parkinsonism, dementia and urinary incontinence. From this experience, stereotactic radiosurgery such as cyber knife and gamma knife therapy, representing a new modality for delivering intense focal radiation, should be come preferred techniques for treating patients with brain metastases, to avoid the potential cognitive side effects of fractionated whole-brain radiotherapy. (author)

  8. A case of leukoencephalopathy caused by radiation and chemotherapy for brain metastasis of breast cancer

    International Nuclear Information System (INIS)

    A case of treatment-related leukoencephalopathy is presented. A patient with breast cancer metastasis to the brain, liver, bone and distant lymph nodes was treated with whole brain radiation and docetaxcel. Eleven months after radiation, magnetic resonance imaging showed diffuse leukoencephalopathy. Twenty-two months after radiation, the patient had gait disturbance, parkinsonism, dementia and urinary incontinence. From this experience, stereotactic radiosurgery such as cyber knife and gamma knife therapy, representing a new modality for delivering intense focal radiation, should be come preferred techniques for treating patients with brain metastases, to avoid the potential cognitive side effects of fractionated whole-brain radiotherapy. (author)

  9. Management ovarian brain metastasis

    International Nuclear Information System (INIS)

    Ovarian cancer is the cause of the most frequent mortality and morbidity from gynaecologist malignant diseases. Nowadays, the standard treatment is the optimal debulkization with the following platinum chemotherapy at all the histological subtypes. Even despite the progress in the surgery and chemotherapy, in the last years 5-year-survival at the patients with initially progressive disease has remained relatively low. One of the least favourable situations is the presence of brain metastasis where the survival is limited only to a few weekends. The brain metastases are not very common at ovarian cancer even despite the fact that in the last years there has been in decrease. Brain metastases typically occur metachromically. Our patient had metachromic metastasis in the brain without the presence of extra cranial disease. Radiotherapy in the area of brain metastasis in a monotherapy was secure and well tolerated at the relatively good efficiency. (author)

  10. Primary monophasic synovial sarcoma lung with brain metastasis diagnosed on transthoracic FNAC: Report of a case with literature review

    OpenAIRE

    Paras Nuwal; Ramakant Dixit; Narender Singh Shah; Anil Samaria

    2012-01-01

    Synovial sarcoma is highly malignant tumor of soft tissues, occurring chiefly in the extremities and limb girdle with a propensity for local recurrence and sometimes metastases to the lungs. Primary synovial sarcoma arising in the lungs is rare and brain metastasis as presentation is further uncommon. We report a case of primary monophasic synovial sarcoma lung presenting with brain metastasis in a 35-year-old male patient. The diagnosis was made on percutaneous transthoracic needle aspiratio...

  11. Brain metastasis from prostate cancer. Report of 13 cases and critical analysis of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Salvati, M.; Frati, A. [INM Neuromed IRCCS, Pozzilli (Italy). Dept. of Neurosurgery; Pavia Univ., Pavia (Italy). IRRCCS Mondino; Russo, N.; Brogna, C.; Piccirilli, M.; Occhiogrosso, G.; Pichierri, A. [Policlinico Umberto 1., Rome (Italy). Dept. of Neurological Sciences-Neurosurgery; D' Andrea, G.; Caroli, E. [Ospedale S. Andrea, Rome (Italy). Dept. of Neurological Sciences-Neurosurgery

    2005-06-15

    Brain metastasis from prostate carcinoma occurs very rarely. We describe 13 patients with single brain metastasis from prostatic cancer. Total removal of the lesions was performed in ten patients. Three patients underwent stereotactic biopsy. All patients were treated with postoperative whole brain radiotherapy (WBRT). Eight patients died for systemic disease after a mean time of 9.2 months with a diagnosis of metastasis. Five patients are still alive at 20, 14, 11, 7 and 6 months, respectively. Even if brain metastasis from prostate cancer is often a terminal event with death occurring within few months from diagnosis, we suggest the same protocol (surgery and/or radiosurgery plus postoperative WBRT) usually adopted to treat brain metastasis from other primitive tumours. A non specific neurological symptomatology and a possible normal dosage of serum specific antigen may contribute to a delay in diagnosis. However, considering the rarity of brain metastasis from prostate carcinoma, standard brain MRI follow-up in men with prostatic cancer does not seem to be necessary yet.

  12. Brain metastasis from prostate cancer. Report of 13 cases and critical analysis of the literature

    International Nuclear Information System (INIS)

    Brain metastasis from prostate carcinoma occurs very rarely. We describe 13 patients with single brain metastasis from prostatic cancer. Total removal of the lesions was performed in ten patients. Three patients underwent stereotactic biopsy. All patients were treated with postoperative whole brain radiotherapy (WBRT). Eight patients died for systemic disease after a mean time of 9.2 months with a diagnosis of metastasis. Five patients are still alive at 20, 14, 11, 7 and 6 months, respectively. Even if brain metastasis from prostate cancer is often a terminal event with death occurring within few months from diagnosis, we suggest the same protocol (surgery and/or radiosurgery plus postoperative WBRT) usually adopted to treat brain metastasis from other primitive tumours. A non specific neurological symptomatology and a possible normal dosage of serum specific antigen may contribute to a delay in diagnosis. However, considering the rarity of brain metastasis from prostate carcinoma, standard brain MRI follow-up in men with prostatic cancer does not seem to be necessary yet

  13. A Case of Primary Colon Carcinoma Demonstrated by FDG PET/CT Imaging After Detection of a Solitary Brain Metastasis

    Directory of Open Access Journals (Sweden)

    Seval Erhamamcı

    2015-06-01

    Full Text Available The detection of brain metastases as the initial manifestation of colorectal carcinoma without liver or lung involvement is extremely rare. Herein we present a case of a 52-year-old male patient with an unusual presentation of colon cancer, with primary lesions demonstrated by fluorine-18-labeled fluorodeoxyglucose (FDG Positron-emission tomography/computed tomography (PET/CT after detection of a solitary brain metastasis. Brain CT images revealed a brain tumor. Histopathologic evaluation indicated metastatic poorly differentiated adenocarcinoma, while his physical examination was normal. The PET/ CT revealed abnormal intense FDG uptake in the right parietal region and in descending colon, with no other abnormal FDG uptake elsewhere in the body. The histopathologic diagnosis of the descending colon lesion revealed moderately differentiated adenocarcinoma. This case indicates that FDG PET/CT imaging may have a positive impact on the evaluation of patients with brain metastasis from an unknown primary.

  14. Primary monophasic synovial sarcoma lung with brain metastasis diagnosed on transthoracic FNAC: Report of a case with literature review

    Directory of Open Access Journals (Sweden)

    Paras Nuwal

    2012-01-01

    Full Text Available Synovial sarcoma is highly malignant tumor of soft tissues, occurring chiefly in the extremities and limb girdle with a propensity for local recurrence and sometimes metastases to the lungs. Primary synovial sarcoma arising in the lungs is rare and brain metastasis as presentation is further uncommon. We report a case of primary monophasic synovial sarcoma lung presenting with brain metastasis in a 35-year-old male patient. The diagnosis was made on percutaneous transthoracic needle aspiration from left-sided pulmonary mass and later confirmed by immunohistochemistry. The utility of preoperative diagnosis by percutaneous aspiration cytology is also stressed.

  15. A Rare Case of Solitary Epidural Brain Metastasis of Neuroepithelioma Tumor in A 14 Years Old Man

    Directory of Open Access Journals (Sweden)

    R. Barikbin

    2008-01-01

    Full Text Available By definition, a peripheral neuroepithelioma is a primary neuroectodermal tumor (PNET arising from peripheral, nonautonomic neural tissue. PNETs are classified into central and peripheral types. Peripheral PNETs are unusual, often highly aggressive, malignant neoplasms, rarely presenting in the head and neck. Soft tissues PNETs arise from nonautonomic nervous system. In this case, we report a 14-years-old male known case of cervical soft tissue neuroepithelioma presenting with a rare form of metastatic disease as extra axial, epidural metastasis to the brain. On histochemichal analysis of this solitary metastasis, as well as original tumor specimens, markers consistent with PNET tumors were identified.

  16. Microenvironment Determinants of Brain Metastasis

    Directory of Open Access Journals (Sweden)

    Zhang Chenyu

    2011-02-01

    Full Text Available Abstract Metastasis accounts for 90% of cancer-related mortality. Brain metastases generally present during the late stages in the natural history of cancer progression. Recent advances in cancer treatment and management have resulted in better control of systemic disease metastatic to organs other than the brain and improved patient survival. However, patients who experience recurrent disease manifest an increasing number of brain metastases, which are usually refractory to therapies. To meet the new challenges of controlling brain metastasis, the research community has been tackling the problem with novel experimental models and research tools, which have led to an improved understanding of brain metastasis. The time-tested "seed-and-soil" hypothesis of metastasis indicates that successful outgrowth of deadly metastatic tumors depends on permissible interactions between the metastatic cancer cells and the site-specific microenvironment in the host organs. Consistently, recent studies indicate that the brain, the major component of the central nervous system, has unique physiological features that can determine the outcome of metastatic tumor growth. The current review summarizes recent discoveries on these tumor-brain interactions, and the potential clinical implications these novel findings could have for the better treatment of patients with brain metastasis.

  17. Brain metastasis treated with Cyberknife

    Institute of Scientific and Technical Information of China (English)

    WANG Zhi-zhen; YUAN Zhi-yong; ZHANG Wen-cheng; YOU Jin-qiang; WANG Ping

    2009-01-01

    Background Cyberknife can greatly raise the fractional dose of stereotactic radiosurgery,thus improving its clinical efficacy.We retrospectively analyzed clinical outcomes of brain metastasis treated with Cyberknife.Methods We analyzed 40 cases of brain metastases treated with Cyberknife in the Tianjin Cancer Hospital from August 1,2006 to August 1,2007,for a total of 68 lesions with maximal diameter of 0.4-7.5 cm (average 1.88 cm).Total hypofractional radiated dosage was 18-36 Gy (5-25 Gy/F,1-5 F) by Cyberknife.We evaluated the remission rate of clinical symptoms,correlation factors to new loci,3-month local control rates,and 3-month and 1-year survival rates.All patients were followed up for more than 14 months.Results After 1 week,clinical remission was 90.0% (36/40).After 3 months,the local control rate and therapeutic effective rate were 77.9% (53/68) and 94.1% (64/68),respectively,as observed by cranium augmentation CT or MRI.The three-month,six-month and 1-year survival rates were 97.5% (39/40),82.5% (33/40) and 67.5% (27/40),respectively.Fourteen patients had neopathy outside the original lesion after 3 months.Neopathy was not correlated with age,whole-brain radiotherapy,number of original lesions,maximum diameter of the original lesion,therapeutic dose per fraction,therapeutic frequency or total therapeutic dose.Conclusions Cyberknife got perfect clinical outcomes by higher dosage per fraction.It is an appropriate and valid treatment shortcut for brain metastasis.

  18. Microenvironment Determinants of Brain Metastasis

    OpenAIRE

    Zhang Chenyu; Yu Dihua

    2011-01-01

    Abstract Metastasis accounts for 90% of cancer-related mortality. Brain metastases generally present during the late stages in the natural history of cancer progression. Recent advances in cancer treatment and management have resulted in better control of systemic disease metastatic to organs other than the brain and improved patient survival. However, patients who experience recurrent disease manifest an increasing number of brain metastases, which are usually refractory to therapies. To mee...

  19. Neuroradiological aspects of brain metastasis of choriocarcinomas

    Energy Technology Data Exchange (ETDEWEB)

    Kida, Y.; Kobayashi, T.; Yoshida, J.; Shibuya, N.; Kageyama, N. (Nagoya Univ. (Japan). Faculty of Medicine)

    1981-04-01

    We have had experience with 24 cases of brain metastasis of choriocarcinoma between 1965 to 1979. Twenty-two cases died, while the other two cases survived. Their neuroradiological findings, especially that of CT scan and angiography, are discussed. The angiograms showed a prominent abnormal neovascularization, with a marked tumor stain in the peripheral zone. However, the central zone appeared avascular or hypovascular. A-V fistulas or early venous filling were seen in two among the 6 cases thus examined. CT scans were studied in 9 lesions of 4 patients. Half of them showed a definite high density, even in plain CT's. A central lucency was found in 7 lesions. In plain CT a highly dense area corresponding to tumors is rare; there have, though, been a few such reports in cases of the brain metastasis of malignant melanoma and colon cancer. This was considered to show hemorrhage associated with the tumor. A follow-up study by CT scan is very important for patients with choriocarcinoma, and also for patients with a hydatidiform mole, because of the rapid progress of the symptoms and signs in cases of brain metastasis.

  20. Brain Metastasis in Pancreatic Cancer

    OpenAIRE

    Marko Kornmann; Doris Henne-Bruns; Jan Scheele; Christian Rainer Wirtz; Thomas Kapapa; Johannes Lemke

    2013-01-01

    Pancreatic cancer is a fatal disease with a 5-year survival rate below 5%. Most patients are diagnosed at an advanced tumor stage and existence of distant metastases. However, involvement of the central nervous system is rare in pancreatic cancer. We retrospectively analyzed all cases of brain metastases in pancreatic cancer reported to date focusing on patient characteristics, clinical appearance, therapy and survival. Including our own, 12 cases of brain metastases originating from pancreat...

  1. Complete remission through icotinib treatment in Non-small cell lung cancer epidermal growth factor receptor mutation patient with brain metastasis: A case report

    OpenAIRE

    Wang Tao; Wang Ruimin; Dong Zhouhuan; Liang Naichao; Chang Ping

    2016-01-01

    Brain metastasis (BM) has been universally recognized as a poor prognostic factor in non-small cell lung cancer (NSCLC). Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) have shown efficacy in treating BM with an EGFR mutation. This paper reports a case of BM patient with EGFR-mutated NSCLC. According to the findings, a complete remission (CR) of the BM was achieved by icotinib treatment without conducting a radiotherapy, which was followed by a resection of the prima...

  2. Mixed adenoneuroendocrine carcinoma with brain metastasis

    Directory of Open Access Journals (Sweden)

    Xiao-ling YAN

    2015-05-01

    Full Text Available Objective To study clinicopathological features, diagnosis, differential diagnosis and prognosis of mixed adenoneuroendocrine carcinoma (MANEC.  Methods One case of MANEC with brain metastasis was reported focusing on the following aspects: clinical manifestations, histopathological features and immunophenotypes, and the relevant literatures were reviewed.  Results A 35-year-old male presented headache and vomiting, and his head CT scan showed a lesion located in the right temporal lobe. The tumor was detected after separating the cerebral cortex during the surgery. The tumor diameter was 3 cm. The tumor was soft and rubbery with ill-defined margins, and rich in blood supply. Under optical microscopy, the tumor was consisted of small round cells of the same size, with focal tumor cells arranged around blood vessels in a pseudorosette manner or papillary manner with brisk mitotic activity. The boundary between tumor and brain tissue was ill-defined. By using immunohistochemical staining, the tumor cells were diffusely positive for synaptophysin (Syn and CD56, and negative for glial fibrillary acidic protein (GFAP, pan cytokeratin (PCK, CD3, CD20, vimentin (Vim, leukocyte common antigen (LCA, thyroid transcription factor-1 (TTF-1, S-100 protein (S-100, neurofilament (NF, nestin (Nes, CK5/6, CK8/18 and CD99. Ki-67 labeling index was about 62%. Sigmoidoscopy was performed later in another hospital and showed a mass in the patient's colon. The colon tumor was biphasic in appearance, and was consisted of two distinct components: isomorphic small round cells and low-middle differentiated adenocarcinoma cells. The small round tumor cells were diffusely positive for Syn and CD56, and negative for PCK. The adenocarcinoma cells showed opposite results.  Conclusions MANEC is a rare tumor, which is defined in 2010 by WHO Classification of Digestive, and to the best of our knowledge, MANEC of the colon with brain metastasis has never been described

  3. The role of radiotherapy in patients with brain metastasis

    International Nuclear Information System (INIS)

    Brain metastases are the most frequent metastatic neurologic complication of systemic cancer. Even if the prognosis of brain metastases is grave, with available treatments, most patients experience effective palliation of neurologic symptoms and meaningful extension of life. We evaluated the clinical features and prognostic factors of the patients who were diagnosed as solid tumors with brain metastasis and received radiotherapy for brain metastases. Between January 1987 and January 1998, 71 patients with brain metastases from solid malignancy were included. We reviewed neurologic symptoms and signs of patients and evaluated improvement of neurologic symptoms and signs. Survival durations after brain metastasis were analysed according to several factors such as age, performance status, primary malignancies, the presence of brain metastasis at initial diagnosis of primary tumor, multiplicity of brain metastases, the presence of metastases other than brain, and treatment method. Frequent symptoms associated with brain metastasis were headache (47.9%), motor weakness (40.8%), nausea and vomiting (19.7%) and mental change (19.7%). Palliation of these symptoms was accomplished in 64.9% of cases. The overall median survival time was 16 weeks and 1- and 2-year survival rates were 15.0% and 5.1 % respectively. Patients without extra cranial metastases (n==27) had longer median survival than patients with extracranial metastases (33 weeks vs 10 weeks, P=(WJ18). In patients with single brain metastasis (n=37), the median survival time was longer in patients treated with surgery plus radiotherapy than in patients treated with radiotherapy alone (40 weeks vs 16 weeks, p=O.0438L Patients who has. brain metastases only constitute a prognostically favorable group and they may be benefited from radiotherapy and surgery if indicated

  4. Brain metastasis in two patients with stage IA papillary serous carcinoma of the uterus

    OpenAIRE

    Narasimhulu, Deepa M.; Neekianund Khulpateea; Keith Meritz; Yiquing Xu

    2015-01-01

    We report two cases of brain metastasis in patients initially diagnosed with extremely early stage UPSC after extensive staging surgery. They did not receive either adjuvant chemotherapy or adjuvant pelvic or vaginal cuff radiation. At the same time that these patients were diagnosed with systemic metastasis, they both had a local “drop” metastasis in the vulva or the vaginal cuff. After the initial response to palliative chemotherapy, they both developed brain metastasis. The pattern of recu...

  5. Screening of brain metastasis through computed tomography in cancer patients

    International Nuclear Information System (INIS)

    The screening of brain metastasis through CT was carried out on 338 patients with malignant tumors of various origins before they manifested neurological symptoms. The primary site of the tumors was a lung in 132 cases, a breast in 48, the gastrointestinal tract in 42, the head or neck in 36, and others (80). Silent (asymptomatic) brain metastasis was detected in 10 cases (2.9%). Nine of these cases harboured lung carcinoma (6.9% out of 132 cases), while one harboured carcinoma of the parotid gland metastasizing in the lungs. Multiple intracerebral metastases were detected in 8 of them and a metastasis single in one, while silent meningeal carcinomatosis was diagnosed in the remaining case. The total number of metastatic foci in the brain from the 9 cases was 66. They ranged from 0.4 to 3.0 cm in diameter; 70% of them were less than 1 cm in diameter. A large lesion was usually found in the silent areas of the cerebral hemispheres. Most of the foci were isodense on CT, and the perifocal low density and mass effects were often defective or, when present, slight, so that a post-contrast study was indispensable for their detection. Adequate treatment(whole-brain irradiation, removal, and/or chemotherapy) for brain metastasis was effectively completed in 9 cases, while one patient refused to be treated. The metastatic foci disappeared on CT in 6 cases and decreased in size in 3. Most of them remained asymptomatic in neurological examination until they died 3-7 months later, mainly of systemic metastases outside the CNS. These results indicate the clinical efficacy of the CT screening of brain metastasis for their early detection; this ensures a length of time sufficient to treat them effectively before neurological deficits develop. The timing and interval at which CT screening should be performed are also discussed. (author)

  6. Intracranial metastasis from a sacrococcygeal chordoma. Case report.

    LENUS (Irish Health Repository)

    Kamel, Mahmoud Hamdy

    2012-02-03

    Chordoma is a locally invasive tumor of low metastatic potential. Only six cases of chordoma that metastasized to the brain are found in the English literature. Most of these lesions were clinically silent and all were associated with extraneural metastases. The authors report a case of symptomatic brain metastasis from a sacrococcygeal chordoma in the absence of other metastases. The incidence, sites, and factors predictive of chordoma metastasis are discussed.

  7. Complete remission through icotinib treatment in Non-small cell lung cancer epidermal growth factor receptor mutation patient with brain metastasis: A case report

    Directory of Open Access Journals (Sweden)

    Wang Tao

    2016-02-01

    Full Text Available Brain metastasis (BM has been universally recognized as a poor prognostic factor in non-small cell lung cancer (NSCLC. Epidermal growth factor receptor (EGFR tyrosine kinase inhibitors (TKIs have shown efficacy in treating BM with an EGFR mutation. This paper reports a case of BM patient with EGFR-mutated NSCLC. According to the findings, a complete remission (CR of the BM was achieved by icotinib treatment without conducting a radiotherapy, which was followed by a resection of the primary lung cancer lesion and lymph nodes. After one-year follow-up, the disease progressed to liver metastasis and liver lesion biopsy showed a T790M mutation. The patient responded well to the combination treatment of AZD9291 and icotinib after the failure of transcatheter arterial chemoembolization (TACE. This case report suggests that icotinib has a sustainable anticancer response to BM and the combination with icotinib and AZD9291 is effective for liver metastasis with T790M.

  8. A rare metastasis from a rare brain tumour

    DEFF Research Database (Denmark)

    Aabenhus, Kristine; Hahn, Christoffer Holst

    2014-01-01

    This case report presents the story of a patient with an oligodendroglioma metastasizing to the bone marrow and to lymph nodes of the neck. The patient had undergone primary brain surgery 13 years prior to the discovery of metastases and radiotherapy directed at the brain tumour two months prior........ Oligodendroglioma are rare primary brain tumours of which extraneural metastasis is even more rare. The incidence of cases like this may be increasing because of better treatment and thus longer survival of patients with oligodendroglioma....

  9. Leptomeningeal metastasis after surgical resection of brain metastases

    OpenAIRE

    Ree, T.C.; Dippel, Diederik; Avezaat, Cees; Vecht, C J; Bent, Martin; Sillevis Smitt, Peter

    1999-01-01

    textabstractOBJECTIVE: To determine the incidence and risk factors for leptomeningeal metastasis after surgery for brain metastasis of solid tumors. METHODS: Review of the records of all patients operated on for brain metastasis between January 1990 and August 1995. RESULTS: In this period 28 patients underwent surgery for brain metastasis, of whom 27 were available for evaluation in this study. Median survival after craniotomy was 11 months. Nine patients (33%) developed leptomeningeal metas...

  10. Stereotactic Irradiation of the Postoperative Resection Cavity for Brain Metastasis: A Frameless Linear Accelerator-Based Case Series and Review of the Technique

    International Nuclear Information System (INIS)

    Purpose: Whole-brain radiation therapy (WBRT) is the standard of care after resection of a brain metastasis. However, concern regarding possible neurocognitive effects and the lack of survival benefit with this approach has led to the use of stereotactic radiosurgery (SRS) to the resection cavity in place of WBRT. We report our initial experience using an image-guided linear accelerator-based frameless stereotactic system and review the technical issues in applying this technique. Methods and Materials: We retrospectively reviewed the setup accuracy, treatment outcome, and patterns of failure of the first 18 consecutive cases treated at Brigham and Women’s Hospital. The target volume was the resection cavity without a margin excluding the surgical track. Results: The median number of brain metastases per patient was 1 (range, 1–3). The median planning target volume was 3.49 mL. The median prescribed dose was 18 Gy (range, 15–18 Gy) with normalization ranging from 68% to 85%. In all cases, 99% of the planning target volume was covered by the prescribed dose. The median conformity index was 1.6 (range, 1.41–1.92). The SRS was delivered with submillimeter accuracy. At a median follow-up of 12.7 months, local control was achieved in 16/18 cavities treated. True local recurrence occurred in 2 patients. No marginal failures occurred. Distant recurrence occurred in 6/17 patients. Median time to any failure was 7.4 months. No Grade 3 or higher toxicity was recorded. A long interval between initial cancer diagnosis and the development of brain metastasis was the only factor that trended toward a significant association with the absence of recurrence (local or distant) (log-rank p = 0.097). Conclusions: Frameless stereotactic irradiation of the resection cavity after surgery for a brain metastasis is a safe and accurate technique that offers durable local control and defers the use of WBRT in select patients. This technique should be tested in larger prospective

  11. Stereotactic Irradiation of the Postoperative Resection Cavity for Brain Metastasis: A Frameless Linear Accelerator-Based Case Series and Review of the Technique

    Energy Technology Data Exchange (ETDEWEB)

    Kelly, Paul J., E-mail: pkelly@lroc.harvard.edu [Department of Radiation Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Boston, MA (United States); Lin Yijie Brittany; Yu, Alvin Y. [Harvard Medical School, Boston, MA (United States); Alexander, Brian M.; Hacker, Fred; Marcus, Karen J.; Weiss, Stephanie E. [Department of Radiation Oncology, Dana-Farber/Brigham and Women' s Cancer Center, Boston, MA (United States)

    2012-01-01

    Purpose: Whole-brain radiation therapy (WBRT) is the standard of care after resection of a brain metastasis. However, concern regarding possible neurocognitive effects and the lack of survival benefit with this approach has led to the use of stereotactic radiosurgery (SRS) to the resection cavity in place of WBRT. We report our initial experience using an image-guided linear accelerator-based frameless stereotactic system and review the technical issues in applying this technique. Methods and Materials: We retrospectively reviewed the setup accuracy, treatment outcome, and patterns of failure of the first 18 consecutive cases treated at Brigham and Women's Hospital. The target volume was the resection cavity without a margin excluding the surgical track. Results: The median number of brain metastases per patient was 1 (range, 1-3). The median planning target volume was 3.49 mL. The median prescribed dose was 18 Gy (range, 15-18 Gy) with normalization ranging from 68% to 85%. In all cases, 99% of the planning target volume was covered by the prescribed dose. The median conformity index was 1.6 (range, 1.41-1.92). The SRS was delivered with submillimeter accuracy. At a median follow-up of 12.7 months, local control was achieved in 16/18 cavities treated. True local recurrence occurred in 2 patients. No marginal failures occurred. Distant recurrence occurred in 6/17 patients. Median time to any failure was 7.4 months. No Grade 3 or higher toxicity was recorded. A long interval between initial cancer diagnosis and the development of brain metastasis was the only factor that trended toward a significant association with the absence of recurrence (local or distant) (log-rank p = 0.097). Conclusions: Frameless stereotactic irradiation of the resection cavity after surgery for a brain metastasis is a safe and accurate technique that offers durable local control and defers the use of WBRT in select patients. This technique should be tested in larger prospective studies.

  12. Concurrent whole brain radiotherapy and bortezomib for brain metastasis

    International Nuclear Information System (INIS)

    Survival of patients with brain metastasis particularly from historically more radio-resistant malignancies remains dismal. A phase I study of concurrent bortezomib and whole brain radiotherapy was conducted to determine the tolerance and safety of this approach in patients with previously untreated brain metastasis. A phase I dose escalation study evaluated the safety of bortezomib (0.9, 1.1, 1.3, 1.5, and 1.7 mg/m2) given on days 1, 4, 8 and 11 of whole brain radiotherapy. Patients with confirmed brain metastasis were recruited for participation. The primary endpoint was the dose-limiting toxicity, defined as any ≥ grade 3 non-hematologic toxicity or grade ≥ 4 hematologic toxicity from the start of treatment to one month post irradiation. Time-to-Event Continual Reassessment Method (TITE-CRM) was used to determine dose escalation. A companion study of brain diffusion tensor imaging MRI was conducted on a subset of patients to assess changes in the brain that might predict delayed cognitive effects. Twenty-four patients were recruited and completed the planned therapy. Patients with melanoma accounted for 83% of all participants. The bortezomib dose was escalated as planned to the highest dose of 1.7 mg/m2/dose. No grade 4/5 toxicities related to treatment were observed. Two patients had grade 3 dose-limiting toxicities (hyponatremia and encephalopathy). A partial or minor response was observed in 38% of patients. Bortezomib showed greater demyelination in hippocampus-associated white matter structures on MRI one month after radiotherapy compared to patients not treated with bortezomib (increase in radial diffusivity +16.8% versus 4.8%; p = 0.0023). Concurrent bortezomib and whole brain irradiation for brain metastasis is well tolerated at one month follow-up, but MRI changes that have been shown to predict delayed cognitive function can be detected within one month of treatment

  13. Treatment of Brain Metastasis from Lung Cancer

    International Nuclear Information System (INIS)

    Brain metastases are not only the most common intracranial neoplasm in adults but also very prevalent in patients with lung cancer. Patients have been grouped into different classes based on the presence of prognostic factors such as control of the primary tumor, functional performance status, age, and number of brain metastases. Patients with good prognosis may benefit from more aggressive treatment because of the potential for prolonged survival for some of them. In this review, we will comprehensively discuss the therapeutic options for treating brain metastases, which arise mostly from a lung cancer primary. In particular, we will focus on the patient selection for combined modality treatment of brain metastases, such as surgical resection or stereotactic radiosurgery (SRS) combined with whole brain irradiation; the use of radiosensitizers; and the neurocognitive deficits after whole brain irradiation with or without SRS. The benefit of prophylactic cranial irradiation (PCI) and its potentially associated neuro-toxicity for both small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) are also discussed, along with the combined treatment of intrathoracic primary disease and solitary brain metastasis. The roles of SRS to the surgical bed, fractionated stereotactic radiotherapy, WBRT with an integrated boost to the gross brain metastases, as well as combining WBRT with epidermal growth factor receptor (EGFR) inhibitors, are explored as well

  14. Experience on breast cancer with brain metastasis in Kanagawa Cancer Center

    International Nuclear Information System (INIS)

    We studied the relationship between clinicopathologic findings and effect of adjuvant therapy on brain metastasis in breast cancer in order to clarify risk factors for brain metastasis in breast cancer patients. We divided patients into a group treated up until December 1999 (Group 1) and a group treated after January 2000 (Group 2), in whom adjuvant therapy was not generalized. Estrogen receptor-negative patients and cases more advanced than T2 showed a high risk of brain metastasis. The time interval to brain metastasis in Group 1 and 2 were 25 and 49.6 months, respectively, showing a significant difference. Taxan derivatives were used in 1.6% of Group 1 and 76% of Group 2. Estrogen receptor negativity, cancer more advanced than T2, and adjuvant therapy are risk factors for brain metastasis. (author)

  15. Genes that mediate breast cancer metastasis to the brain

    OpenAIRE

    Bos, Paula D.; Zhang, Xiang H.-F.; Nadal, Cristina; Shu, Weiping; Gomis, Roger R; Nguyen, Don X.; Minn, Andy J.; Vijver, Marc; Gerald, William; Foekens, John A.; Massagué, Joan

    2009-01-01

    The molecular basis for breast cancer metastasis to the brain is largely unknown1,2. Brain relapse typically occurs years after the removal of a breast tumour2–4, suggesting that disseminated cancer cells must acquire specialized functions to overtake this organ. Here we show that breast cancer metastasis to the brain involves mediators of extravasation through non-fenestrated capillaries, complemented by specific enhancers of blood–brain barrier crossing and brain colonization. We isolated c...

  16. Association between brain metastasis from lung cancer and the serum level of myelin basic protein

    OpenAIRE

    Liu, Wei; Zhao, Jing; WEI, YUJUAN

    2015-01-01

    The aim of the present study was to determine the association between the expression of myelin basic protein in the serum and the metastasis of lung cancer to the brain. A total of 68 lung cancer patients, treated in the Department of Respiratory Medicine of the People’s Hospital of Rizhao (Rizhao, China), were divided into two groups, those with brain metastasis (32 cases) and those without brain metastasis (36 cases). The expression levels of myelin basic protein were measured for all the p...

  17. Brain metastasis in two patients with stage IA papillary serous carcinoma of the uterus.

    Science.gov (United States)

    Narasimhulu, Deepa M; Khulpateea, Neekianund; Meritz, Keith; Xu, Yiquing

    2015-08-01

    We report two cases of brain metastasis in patients initially diagnosed with extremely early stage UPSC after extensive staging surgery. They did not receive either adjuvant chemotherapy or adjuvant pelvic or vaginal cuff radiation. At the same time that these patients were diagnosed with systemic metastasis, they both had a local "drop" metastasis in the vulva or the vaginal cuff. After the initial response to palliative chemotherapy, they both developed brain metastasis. The pattern of recurrence with the lack of adjuvant treatment underscores the urgent need in further evaluation of the potential benefits of adjuvant treatment, including chemotherapy and possibly in combination with radiation in this highly aggressive disease. PMID:26425708

  18. GAMMA KNIFE RADIOSURGERY OF BRAIN METASTASIS FROM MALIGNANT PLEURAL MESOTHELIOMA – REPORT OF THREE CASES WITH AUTOPSY STUDY IN A CASE

    OpenAIRE

    Kobayashi, Tatsuya; TSUGAWA, TAKAHIKO; Hashizume, Chisa; Toriyama, Takanobu; Asai, Masami; Mori, Yoshimasa; Shibamoto, Yuta

    2014-01-01

    ABSTRACT The median survival time of malignant pleural mesothelioma (MPM) has been 9 months. Given the short survival, there have been only few cases in which brain metastases have been diagnosed and treated before death. Three cases of brain metastases treated by gamma knife radiosurgery (GKR) are reported. Case 1 showed a metastatic lesion in the right frontal lobe which was treated by GKR two years after diagnosis of MPM. The lesion markedly reduced and the symptoms were improved, But the ...

  19. Blood-Brain Barrier Integrity and Breast Cancer Metastasis to the Brain

    OpenAIRE

    Hava Karsenty Avraham; Shalom Avraham; Christopher Sy; Lili Wang; Farheen Arshad

    2011-01-01

    Brain metastasis, an important cause of cancer morbidity and mortality, occurs in at least 30% of patients with breast cancer. A key event of brain metastasis is the migration of cancer cells through the blood-brain barrier (BBB). Although preventing brain metastasis is immensely important for survival, very little is known about the early stage of transmigration and the molecular mechanisms of breast tumor cells penetrating the BBB. The brain endothelium plays an important role in brain meta...

  20. Management of brain metastasis in a patient with advanced epithelial ovarian carcinoma by gamma-knife radiosurgery

    OpenAIRE

    Nikolaou Marinos; Stamenković Srđan; Stergiou Christos; Skarleas Christos; Torrens Michael

    2015-01-01

    Introduction. Brain metastases from epithelial ovarian cancer (EOC) are rare events. We present a rare case of single ovarian cancer metastasis to the brain treated with gamma-knife radiosurgery (GKRS). Case Outline. A 65-year-old woman with advanced EOC presented with severe neurologic symptoms. A single brain metastasis of 3.2 cm with surrounding edema in the left parietal lobe was detected by brain magnetic resonance imaging (MRI) scan during the work-up...

  1. Radiotherapy for metastasis from breast and lung cancer. Bone and Brain metastasis

    International Nuclear Information System (INIS)

    Bone or brain metastasis is the common and serious condition restricting the quality of life (QOL) of the cancer patients and radiotherapy frequently plays an important role in relief of their symptoms. Because radiotherapy is given with palliative intent to the patients with limited, if variable, life expectancy, radiation schedules need to be identified which give maximum patient benefit with minimum associated morbidity and minimum disturbance of the patients' remaining life. We retrospectively analyzed 222 patients with the bone or the brain metastasis from lung or breast cancer to evaluate the effect of radiotherapy on their prognosis and QOL. The 3-year survival rates of the patients with breast and lung cancer were 21% and 3%, respectively (p<0.0001), and breast cancer patients seemed to have better prognosis than lung cancer patients for both bone metastasis (p<0.0001) and brain metastasis (p=0.09). Symptom relief by radiotherapy was obtained 84% for bone metastasis and 64% for brain metastasis and it was not affected by primary lesion (lung or breast). Sixty seven per cent of the bone and the brain metastasis was derived from adenocarcinoma and it had a tendency to give the better prognosis comparing with squamous cell carcinoma. Radiation schedules should be flexibly corresponded to the patients' tumor type (metastatic site, primary disease or histology), even if it is 'just' a palliative therapy, considering their prognosis and QOL. (author)

  2. Diagnostic study with CT and MR on the metastasis of malignant brain tumors

    International Nuclear Information System (INIS)

    Forty cases of malignant brain tumors with metastasis which involved 14 malignant gliomas, 15 medulloblastomas and 11 germ cell tumors were studied on CT and MRI. In malignant glioma, transventricular metastasis was seen most frequently, estimating 8 cases (57%) of 14 malignant gliomas with metastasis and showing ependymal-subependymal enhancement on contrast-enhanced CT (CECT). Most of the medulloblastoma with metastasis demonstrated diffuse subarachnoid seeding in the craniospinal space and on image analysis diffuse sulcal-cisternal enhancement was characterized. Trans-ventricular metastasis in medulloblastoma was less than in malignant glioma showing 3 cases (20%) of 15 medulloblastomas, which in most cases showed a nodular tumor in the ventricular wall by metastasis. There were six patients who, on the first admission, were found to have germ cell tumors of the broad infiltrating type with multiple lesions. The tumor sites of metastasis were different from those with malignant gliomas, being frequently localized in the pineal and/or the suprasellar region, on the ventricular wall and in the basal ganglia. Metastasis to a remote area in germ cell tumors was to spinal cords, to the ventricular wall and basal cistern around the brain stem by CSF dissemination, to the lung by hematogenous metastasis and to the peritoneal wall or organs through V-P shunt tube. T1-weighted Gd-DTPA MRI was more useful and sensitive than CECT for diagnosis of the leptomeningeal metastasis, particularly for sulcal-cisternal and spinal metastasis. It will be used more often as the first choice for diagnosis of intrathecal metastasis in the future. (author)

  3. Diagnostic study with CT and MR on the metastasis of malignant brain tumors

    Energy Technology Data Exchange (ETDEWEB)

    Miyagami, Mitsusuke; Kasahara, Eishi; Tazoe, Makoto; Tsubokawa, Takashi (Nihon Univ., Tokyo (Japan). School of Medicine)

    1990-08-01

    Forty cases of malignant brain tumors with metastasis which involved 14 malignant gliomas, 15 medulloblastomas and 11 germ cell tumors were studied on CT and MRI. In malignant glioma, transventricular metastasis was seen most frequently, estimating 8 cases (57%) of 14 malignant gliomas with metastasis and showing ependymal-subependymal enhancement on contrast-enhanced CT (CECT). Most of the medulloblastoma with metastasis demonstrated diffuse subarachnoid seeding in the craniospinal space and on image analysis diffuse sulcal-cisternal enhancement was characterized. Trans-ventricular metastasis in medulloblastoma was less than in malignant glioma showing 3 cases (20%) of 15 medulloblastomas, which in most cases showed a nodular tumor in the ventricular wall by metastasis. There were six patients who, on the first admission, were found to have germ cell tumors of the broad infiltrating type with multiple lesions. The tumor sites of metastasis were different from those with malignant gliomas, being frequently localized in the pineal and/or the suprasellar region, on the ventricular wall and in the basal ganglia. Metastasis to a remote area in germ cell tumors was to spinal cords, to the ventricular wall and basal cistern around the brain stem by CSF dissemination, to the lung by hematogenous metastasis and to the peritoneal wall or organs through V-P shunt tube. T{sub 1}-weighted Gd-DTPA MRI was more useful and sensitive than CECT for diagnosis of the leptomeningeal metastasis, particularly for sulcal-cisternal and spinal metastasis. It will be used more often as the first choice for diagnosis of intrathecal metastasis in the future. (author).

  4. Metastatic neuroblastoma in the brain parenchyma; a case report

    International Nuclear Information System (INIS)

    During childhood, neuroblastoma is a relatively common malignant neoplasm which commonly metastasizes to other organs. Metastasis to the central nervous system from an extracranial neuroblastoma is rare, however, and brain parenchymal metastasis is very rare. We describe a case of brain parenchymal metastasis from primary abdominal neuroblastoma, and review the literature

  5. Differential Reactions of Microglia to Brain Metastasis of Lung Cancer

    OpenAIRE

    He, Bei Ping; Wang, Jian Jun; Zhang, Xian; Wu, Yan; Wang, Miao; Bay, Boon-Huat; Chang, Alex Yuang-Chi

    2006-01-01

    The brain is a common metastatic site for various types of cancers, especially lung cancer. Patients with brain metastases have a poor prognosis in spite of radiotherapy and/or chemotherapy. It is postulated that immune cells in the brain may play a major role in cancer metastasis, dormancy, and relapse. Although microglia may serve as a major component in the brain immune system, the interaction between metastatic cancer cells and microglia is still largely unknown and remains to be elucidat...

  6. Brain metastasis evaluation of lung carcinoma by PET-MRI as a guide therapeutic

    International Nuclear Information System (INIS)

    We report a clinical case of a 44 year-old woman with diagnosis of epidermoid lung carcinoma and three brain metastasis treated with surgery and radiation therapy. Three brain PET-MRI studies performed during the follow-up were useful and crucial for the detection of radionecrosis and tumor relapse. Brain PET-MRI is an important diagnostic tool in selected patients with cerebral metastases of lung cancer

  7. In vivo modeling and molecular characterization: a path towards targeted therapy of melanoma brain metastasis

    Directory of Open Access Journals (Sweden)

    AvitalGaziel-Sovran

    2013-05-01

    Full Text Available Brain metastasis from melanoma remains mostly incurable and the main cause of death from the disease. Early stage clinical trials and case studies show some promise for targeted therapies in the treatment of melanoma brain metastasis. However, the progression-free survival for currently available therapies, although significantly improved, is still very short. The development of new potent agents to eradicate melanoma brain metastasis relies on the elucidation of the molecular mechanisms that drive melanoma cells to reach and colonize the brain. The discovery of such mechanisms depends heavily on pre-clinical models that enable the testing of candidate factors and therapeutic agents in vivo. In this review we summarize the effects of available targeted therapies on melanoma brain metastasis in the clinic. We provide an overview of existing pre-clinical models to study the disease and discuss specific molecules and mechanisms reported to modulate different aspects of melanoma brain metastasis and finally, by integrating both clinical and basic data, we summarize both opportunities and challenges currently presented to researchers in the field.

  8. Differentiation of local tumor recurrence from radiation-induced changes after stereotactic radiosurgery for treatment of brain metastasis: case report and review of the literature

    International Nuclear Information System (INIS)

    Structural follow-up magnetic resonance imaging (MRI) after stereotactic radiosurgery (SRS) for brain metastases frequently displays local changes in the area of applied irradiation, which are often difficult to interpret (e.g., local tumor recurrence, radiation-induced changes). The use of stereotactic biopsy for histological assessment of these changes has a high diagnostic accuracy and can be considered as method of choice. In order to solve this relevant clinical problem non-invasively, advanced MRI techniques and amino acid positron-emission-tomography (PET) are increasingly used. We report the long-term follow-up of a patient who had been treated with linear accelerator based SRS for cerebral metastases of a lung cancer. Fifty-eight months after SRS, the differentiation of local recurrent brain metastasis from radiation-induced changes using structural MRI was difficult. For further differentiation, perfusion-weighted MRI (PWI), proton magnetic resonance spectroscopy (MRS), and 11C-methyl-L-methionine (MET) PET was performed. Due to artifacts and technical limitations, PWI MRI and MRS findings were not conclusive. In contrast, MET PET findings were suggestive for radiation-induced changes. Finally, a stereotactic biopsy for histological assessment of these changes demonstrated clearly a radiation-induced necrosis and the absence of vital tumor. The use of stereotactic biopsy for histological assessment of indistinguishable lesions on structural MRI after SRS for treatment of brain metastasis represents a highly reliable method to differentiate local tumor recurrence from radiation-induced changes. In this field, results of studies with both advanced MRI techniques and amino acid PET suggest encouraging results. However, artifacts and technical limitations (e.g., lesion size) are still a problem and comparative studies are needed to investigate the relationship, diagnostic performance, and complementary character of advanced MRI techniques and amino acid PET

  9. Brain metastasis in two patients with stage IA papillary serous carcinoma of the uterus

    Directory of Open Access Journals (Sweden)

    Deepa M. Narasimhulu

    2015-08-01

    Full Text Available We report two cases of brain metastasis in patients initially diagnosed with extremely early stage UPSC after extensive staging surgery. They did not receive either adjuvant chemotherapy or adjuvant pelvic or vaginal cuff radiation. At the same time that these patients were diagnosed with systemic metastasis, they both had a local “drop” metastasis in the vulva or the vaginal cuff. After the initial response to palliative chemotherapy, they both developed brain metastasis. The pattern of recurrence with the lack of adjuvant treatment underscores the urgent need in further evaluation of the potential benefits of adjuvant treatment, including chemotherapy and possibly in combination with radiation in this highly aggressive disease.

  10. Outcomes in 12 gynecologic cancer patients with brain metastasis: a single center’s experience

    OpenAIRE

    CÖMERT, Esra ÇABUK; BİLDACI, Tevfik Berk; KARAKAYA, Burcu KISA; TARHAN, Nefise Çağla; Özlem ÖZEN; Gülşen, Salih; Dursun, Polat; Ayhan, Ali

    2012-01-01

    To present 12 gynecologic cancer cases with brain metastasis and a discussion of the relevant literature. Gynecologic malignancy is the second most common cancer in elderly women, following breast cancer. These cancers usually spread locally at first, and common distant metastatic sites are the lungs, liver, spleen, and distant lymph nodes. The brain is not a usual site of metastatic involvement. Materials and methods: The study included 12 cases with various gynecologic malignancies that w...

  11. Metastasis of Pregnancy-Associated Breast Cancer (Suspected to Be Hereditary Breast and Ovarian Cancer) to the Brain, Diagnosed at 18 Weeks' Gestation: A Case Report and Review of the Literature

    OpenAIRE

    Tomohiro Okuda; Sakura Yamamoto; Seiki Matsuo; Hisashi Kataoka; Jo Kitawaki

    2016-01-01

    We report a case of pregnancy-associated breast cancer with metastasis to the brain, likely resulting from hereditary breast and ovarian cancer (HBOC). A 35-year-old woman (gravida 2, para 0-1-0-1) underwent a right mastectomy and right axillary dissection after a cesarean section at 30 years of age; her mother died at 47 years of age due to breast cancer. Histopathological examination indicated an invasive ductal carcinoma with triple-negative cancer (cancer stage 2B [pT3N0M0]). The patient ...

  12. Brain metastasis in breast cancer: a comprehensive literature review.

    Science.gov (United States)

    Rostami, Rezvan; Mittal, Shivam; Rostami, Pooya; Tavassoli, Fattaneh; Jabbari, Bahman

    2016-05-01

    This comprehensive review provides information on epidemiology, size, grade, cerebral localization, clinical symptoms, treatments, and factors associated with longer survival in 14,599 patients with brain metastasis from breast cancer; the molecular features of breast cancers most likely to develop brain metastases and the potential use of these predictive molecular alterations for patient management and future therapeutic targets are also addressed. The review covers the data from 106 articles representing this subject in the era of modern neuroimaging (past 35 years). The incidence of brain metastasis from breast cancer (24 % in this review) is increasing due to advances in both imaging technologies leading to earlier detection of the brain metastases and introduction of novel therapies resulting in longer survival from the primary breast cancer. The mean age at the time of breast cancer and brain metastasis diagnoses was 50.3 and 48.8 years respectively. Axillary node metastasis was noted in 32.8 % of the patients who developed brain metastasis. The median time intervals between the diagnosis of breast cancer to identification of brain metastasis and from identification of brain metastasis to death were 34 and 15 months, respectively. The most common symptoms experienced in patients with brain metastasis consisted of headache (35 %), vomiting (26 %), nausea (23 %), hemiparesis (22 %), visual changes (13 %) and seizures (12 %). A majority of the patients had multiple metastases (54.2 %). Cerebellum and frontal lobes were the most common sites of metastasis (33 and 16 %, respectively). Of the primary tumors for which biomarkers were recorded, 37 % were estrogen receptor (ER)+, 41 % ER-, 36 % progesterone receptor (PR)+, 34 % PR-, 35 % human epithelial growth factor receptor 2 (HER2)+, 41 % HER2-, 27 % triple negative and 18 % triple positive (TP). Treatment in most patients consisted of a multimodality approach often with two or more of the

  13. Non-coding RNAs in cancer brain metastasis.

    Science.gov (United States)

    Wu, Kerui; Sharma, Sambad; Venkat, Suresh; Liu, Keqin; Zhou, Xiaobo; Watabe, Kounosuke

    2016-01-01

    More than 90% of cancer death is attributed to metastatic disease, and the brain is one of the major metastatic sites of melanoma, colon, renal, lung and breast cancers. Despite the recent advancement of targeted therapy for cancer, the incidence of brain metastasis is increasing. One reason is that most therapeutic drugs can't penetrate blood-brain-barrier and tumor cells find the brain as sanctuary site. In this review, we describe the pathophysiology of brain metastases to introduce the latest understandings of metastatic brain malignancies. This review also particularly focuses on non-coding RNAs and their roles in cancer brain metastasis. Furthermore, we discuss the roles of the extracellular vesicles as they are known to transport information between cells to initiate cancer cell-microenvironment communication. The potential clinical translation of non-coding RNAs as a tool for diagnosis and for treatment is also discussed in this review. At the end, the computational aspects of non-coding RNA detection, the sequence and structure calculation and epigenetic regulation of non-coding RNA in brain metastasis are discussed. PMID:26709907

  14. Treatment for brain metastasis from lung cancer in the era of radiosurgery

    International Nuclear Information System (INIS)

    The treatment for brain metastasis has undergone remarkable changes since the development of radiosurgery. We investigated the results of treatment for brain metastasis from lung cancer since the initiation of gamma knife radiosurgery (GKRS) and we discuss the usefulness of GKRS combined with other treatments in cases with recurrence. We treated 142 patients with brain metastasis from lung cancer. Sixteen patients were treated surgically, 11 patients were treated with whole brain radiation therapy (WBRT), and 115 patients were treated with GKRS. Our treatment plan is to use GKRS in cases with less than 5 lesions and lesions less than 3 cm in mean diameter. We use WBRT in cases with 5 or more lesions, and surgery in cases with lesions 3 cm or larger. If new lesions or tumor regrowth appeared after the initial treatment, we retreated them with one of the methods mentioned above. Twice or three-time treatments were performed in 30 patients. Median survival including all cases was 10 months and the number of deaths due to local treatment failure was only 5 (6.5%) out of the total 77 deaths which occurred. We were able to carry out less invasive treatment for brain metastasis from lung cancer by utilizing GKRS. Though we have to consider the indications for other treatments, we can say that radiosurgery is usually the treatment of first choice for brain metastasis from lung caner. When new lesions appear in cases where a particular initial treatment was used, it is possible to maintain or improve the quality of life by retreatment, using a combination of GKRS, surgery or WBRT, to prolong the patient's life. (author)

  15. Capturing Changes in the Brain Microenvironment during Initial Steps of Breast Cancer Brain Metastasis

    OpenAIRE

    Lorger, Mihaela; Felding-Habermann, Brunhilde

    2010-01-01

    Brain metastases are difficult to treat and mostly develop late during progressive metastatic disease. Patients at risk would benefit from the development of prevention and improved treatments. This requires knowledge of the initial events that lead to brain metastasis. The present study reveals cellular events during the initiation of brain metastasis by breast cancer cells and documents the earliest host responses to incoming cancer cells after carotid artery injection in immunodeficient an...

  16. Mandibular metastasis of cholangiocarcinoma: A case report

    OpenAIRE

    You, Tae Min; Kim, Kee-Deog; Jeong, Ho-Gul; Park, Wonse

    2015-01-01

    Tumors metastasizing from distant regions to the oral and maxillofacial region are uncommon, comprising only 1%-2% of all malignancies. Cholangiocarcinoma is a malignancy that arises from cholangiocytes, which are epithelial cells that line the bile ducts. These cancers are difficult to diagnose and have a poor prognosis. In this paper, we report a rare case of mandibular metastasis of cholangiocarcinoma diagnosed at the primary site and discuss the radiographic findings observed in this case.

  17. Brain metastasis from pheochromocytoma in a patient with multiple endocrine neoplasia type 2A.

    Science.gov (United States)

    Gentile, S; Rainero, I; Savi, L; Rivoiro, C; Pinessi, L

    2001-12-01

    Neurological involvement in multiple endocrine neoplasia (MEN) syndrome is uncommon. Notalgia paresthetica (pruritus localized in an area between D2 and D6 dermatomes) is the neurological symptom more frequently described in patients with MEN 2A. The authors report the unusual case of a MEN 2A patient with a brain metastasis from a pheochromocytoma. PMID:11677427

  18. Molecular Aspects of Breast Cancer Metastasis to the Brain

    OpenAIRE

    Leonard Da Silva; Simpson, Peter T.; Sunil R. Lakhani; Saunus, Jodi M; Majid Momeny

    2011-01-01

    Our knowledge of the biology underlying the development of brain metastases (BM) from breast cancer has improved over the last decade due to large clinical epidemiological studies, animal models of metastasis, and the use of high-resolution gene expression profiling technologies. However, there are still major gaps in our understanding of the mechanisms utilized by breast cancer cells to colonize the brain microenvironment, thus our arsenal of therapies remains relatively nonspecific, and the...

  19. The vascular basement membrane as "soil" in brain metastasis.

    Directory of Open Access Journals (Sweden)

    W Shawn Carbonell

    Full Text Available Brain-specific homing and direct interactions with the neural substance are prominent hypotheses for brain metastasis formation and a modern manifestation of Paget's "seed and soil" concept. However, there is little direct evidence for this "neurotropic" growth in vivo. In contrast, many experimental studies have anecdotally noted the propensity of metastatic cells to grow along the exterior of pre-existing vessels of the CNS, a process termed vascular cooption. These observations suggest the "soil" for malignant cells in the CNS may well be vascular, rather than neuronal. We used in vivo experimental models of brain metastasis and analysis of human clinical specimens to test this hypothesis. Indeed, over 95% of early micrometastases examined demonstrated vascular cooption with little evidence for isolated neurotropic growth. This vessel interaction was adhesive in nature implicating the vascular basement membrane (VBM as the active substrate for tumor cell growth in the brain. Accordingly, VBM promoted adhesion and invasion of malignant cells and was sufficient for tumor growth prior to any evidence of angiogenesis. Blockade or loss of the beta1 integrin subunit in tumor cells prevented adhesion to VBM and attenuated metastasis establishment and growth in vivo. Our data establishes a new understanding of CNS metastasis formation and identifies the neurovasculature as the critical partner for such growth. Further, we have elucidated the mechanism of vascular cooption for the first time. These findings may help inform the design of effective molecular therapies for patients with fatal CNS malignancies.

  20. Metastasis of Pregnancy-Associated Breast Cancer (Suspected to Be Hereditary Breast and Ovarian Cancer to the Brain, Diagnosed at 18 Weeks’ Gestation: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Tomohiro Okuda

    2016-01-01

    Full Text Available We report a case of pregnancy-associated breast cancer with metastasis to the brain, likely resulting from hereditary breast and ovarian cancer (HBOC. A 35-year-old woman (gravida 2, para 0-1-0-1 underwent a right mastectomy and right axillary dissection after a cesarean section at 30 years of age; her mother died at 47 years of age due to breast cancer. Histopathological examination indicated an invasive ductal carcinoma with triple-negative cancer (cancer stage 2B [pT3N0M0]. The patient refused adjuvant therapy because of the risk of infertility. After 4 years, she became pregnant naturally. At 18 weeks’ gestation, she experienced aphasia and dyslexia due to brain metastasis. The pregnancy was terminated at 21 weeks’ gestation after thorough counseling. Her family history, young-onset disease, and histopathological findings suggested HBOC. She declined genetic testing for BRCA1/2, though genetic counseling was provided. In cases of pregnancy-related breast cancer, consideration must be given to whether the pregnancy should be continued and to posttreatment fertility. HBOC should also be considered. Genetic counseling should be provided and the patient should be checked for the BRCA mutation, as it is meaningful for the future of any potential children. Genetic counseling should be provided even if the cancer is advanced or recurrent.

  1. Sudden hearing loss due to internal auditory canal metastasis of Her2-positive gastric cancer: A case report

    OpenAIRE

    Kim, Chang-Hee; Shin, Jung Eun; Roh, Hong Gee; LEE, JONG SIK; Yoon, So Young

    2014-01-01

    Internal auditory canal (IAC) metastasis due to leptomeningeal carcinomatosis (LMC) from gastric cancer (GC) has rarely been reported. Early manifestation of symptoms, such as hearing loss, vertigo and facial paralysis, in cases of IAC metastasis due to LMC may facilitate the early detection of brain metastasis. To the best of our knowledge, the present study is the first to report IAC metastasis due to LMC in human epidermal growth factor receptor 2 (Her2)-positive GC. This study reports a c...

  2. Melanoma Brain Metastasis: Mechanisms, Models, and Medicine.

    Science.gov (United States)

    Kircher, David A; Silvis, Mark R; Cho, Joseph H; Holmen, Sheri L

    2016-01-01

    The development of brain metastases in patients with advanced stage melanoma is common, but the molecular mechanisms responsible for their development are poorly understood. Melanoma brain metastases cause significant morbidity and mortality and confer a poor prognosis; traditional therapies including whole brain radiation, stereotactic radiotherapy, or chemotherapy yield only modest increases in overall survival (OS) for these patients. While recently approved therapies have significantly improved OS in melanoma patients, only a small number of studies have investigated their efficacy in patients with brain metastases. Preliminary data suggest that some responses have been observed in intracranial lesions, which has sparked new clinical trials designed to evaluate the efficacy in melanoma patients with brain metastases. Simultaneously, recent advances in our understanding of the mechanisms of melanoma cell dissemination to the brain have revealed novel and potentially therapeutic targets. In this review, we provide an overview of newly discovered mechanisms of melanoma spread to the brain, discuss preclinical models that are being used to further our understanding of this deadly disease and provide an update of the current clinical trials for melanoma patients with brain metastases. PMID:27598148

  3. Low incidence of melanoma brain metastasis in the hippocampus

    International Nuclear Information System (INIS)

    Aims: ANZMTG 01.07 WBRTMel is a phase 3 randomized trial to address the role of whole brain radiation therapy (WBRT) after local treatment of 1–3 melanoma brain metastases. Modern radiation therapy technologies can now conformally spare the hippocampus during WBRT and therefore potentially reduce the risk of neurocognitive deficit. The aims of this study were to report the prevalence of melanoma metastases within the hippocampal sparing region and to identify variables that correlate with the presence of metastases within the hippocampal sparing region. Methods: The pre-local treatment MRI scans of 77 eligible WBRTMel patients were used to contour the individual metastasis and the hippocampus. The volume, location and closest distance of each metastasis to the hippocampus were recorded. Binary logistic regression was performed to assess the influence of factors on the location of a metastasis within 5 mm of the hippocampus. Results: The median age was 61 and 66% were male. The distribution of the 115 metastases was frontal (50, 43.5%), parietal (23, 20.0%), temporal (13, 11.2%), occipital (18, 15.7%), cerebellum (10, 8.6%) and pineal gland (1, 1.0%). The median aggregate volume of the metastasis was 3516 mm3. None of the metastases were within the hippocampus. Four patients (5.2%) had metastases within 5 mm of the hippocampus. The median distance from metastasis to the nearest hippocampus was 37.2 mm. Only the total volume of metastases was a significant predictor for the risk of a metastasis within the hippocampal sparing region (OR 1.071, 95% CI: 1.003–1.144, p = 0.040). Conclusions: This study confirmed a low incidence of melanoma metastasis in the hippocampal sparing region at diagnosis. Given the lack of randomized data on the safety and benefit of hippocampal sparing WBRT, the current WBRTMel trial provides the opportunity to explore the feasibility of this technique

  4. Choriocarcinoma: a rare case of stomach metastasis

    Directory of Open Access Journals (Sweden)

    Raju Agarwal

    2014-06-01

    Full Text Available Choriocarcinoma is a rare form of cancer which commonly occurs in women of reproductive age, rarely in post-menopausal women and in women under 20 years of age. We report a rare case of uterine choriocarcinoma with stomach metastasis in a 29 year-old woman who presented with upper gastrointestinal symptoms. The presented case report emphasizes the need for innovative treatment approach and appropriate diagnostic technology to enable early diagnosis and correct treatment. Furthermore the case highlights the need for healthcare workers to consider rare causes of gastrointestinal signs and symptoms. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 787-789

  5. Treatment of Brain Metastasis from Lung Cancer

    OpenAIRE

    Alexander Chi; Ritsuko Komaki

    2010-01-01

    Brain metastases are not only the most common intracranial neoplasm in adults but also very prevalent in patients with lung cancer. Patients have been grouped into different classes based on the presence of prognostic factors such as control of the primary tumor, functional performance status, age, and number of brain metastases. Patients with good prognosis may benefit from more aggressive treatment because of the potential for prolonged survival for some of them. In this review, we will com...

  6. Radiation therapy for brain metastasis from lung cancer

    International Nuclear Information System (INIS)

    The prognosis for patients with brain metastasis from lung cancer following radiation therapy was evaluated. Seventy-eight patients received brain irradiation in the Osaka Prefectural Habikino Hospital between April 1985 and March 1989. Almost all patients had conventional radiotherapy of the whole brain, with a single dose of 2 or 3 Gy. Patients characteristics associated with favorable prognosis were as follows: Performance status of 0∼1, age≤49, female, histology of adenocarcinoma. Patients who received radiotherapy of 56 Gy10 or more, had longer survival time. The findings in the brain CT were evaluated, but the number, size, site of metastases, and mass effect to ventricular system were not related to the prognosis. The overall median survival was 3.5 months and the 1-year survival rate was 9.0%. Further clinical studies are necessary to improve the prognosis in brain metastases. (author)

  7. Brain metastasis from hepatocellular carcinoma: the role of surgery as a prognostic factor

    International Nuclear Information System (INIS)

    The incidence of brain metastasis from hepatocellular carcinoma (HCC) is expected to increase as a result of prolonged survival due to the recent advances in HCC treatment. However, there is no definite treatment strategy for brain metastasis from HCC mainly due to its rarity and dismal prognosis. To provide helpful recommendations in treatment of brain metastasis from HCC, the authors aimed to identify prognostic factors that influence survival rates with a review of the recently published data. Thirty-three cases of brain metastasis, whose incidence was 0.65%, were selected from a total of 5015 HCC patients and reviewed retrospectively in terms of clinical and radiological features. Median overall survival time after diagnosis of brain metastasis was 10.4 weeks (95% confidence interval [CI], 5.1-15.7 weeks) with 1-, 6- and 12-month survival rates, of 79%, 24% and 6%, respectively. Median survival of the patients treated with surgical resection or surgical resection followed by whole-brain radiation therapy (WBRT) (25.3 weeks; range, 15.8-34.8 weeks) was longer than that of the patients treated with gamma knife surgery (GKS), WBRT, or GKS followed by WBRT (10.4 weeks; range, 7.5-13.3 weeks) as well as that of patients treated with only steroids (1 week; range, 0.0-3.3 weeks) (p < 0.001). Child-Pugh’s classification A group had a longer median survival time than Child-Pugh’s classification B or C group (14.4 weeks vs 8.4 weeks, p = 0.038). RPA class I & II group had also a longer median survival time than RPA class III group did (13.4 weeks vs 2.4 weeks, p = 0.001). Surgical resection (hazard ratio [HR] 0.23, 95% CI 0.08-0.66, p = 0.006) and good liver function at the time of brain metastasis (HR 0.25, 95% CI 0.09-0.69, p = 0.007) were found to be the powerful prognostic factors for favorable survival in the multivariate analysis. In addition, presence of intratumoral hemorrhage was a statistically significant prognostic factor for survival. Although HCC

  8. Endoscopy-verified occult subependymal dissemination of glioblastoma and brain metastasis undetected by MRI: prognostic significance

    Directory of Open Access Journals (Sweden)

    Iacoangeli M

    2012-12-01

    Full Text Available Maurizio Iacoangeli,1 Alessandro Di Rienzo,1 Roberto Colasanti,1 Antonio Zizzi,2 Maurizio Gladi,1 Lorenzo Alvaro,1 Niccolò Nocchi,1 Lucia Giovanna Maria Di Somma,1 Marina Scarpelli,2 Massimo Scerrati11Department of Neurosurgery, 2Department of Pathology, Università Politecnica delle Marche, Umberto I General Hospital, Ancona, ItalyAbstract: Although various prognostic indices exist for patients with malignant brain tumors, the prognostic significance of the subependymal spread of intracranial tumors is still a matter of debate. In this paper, we report the cases of two intraventricular lesions, a recurrent glioblastoma multiforme (GBM and a brain metastasis, each successfully treated with a neuroendoscopic approach. Thanks to this minimally invasive approach, we achieved good therapeutic results: we obtained a histological diagnosis; we controlled intracranial hypertension by treating the associated hydrocephalus and, above all, compared with a microsurgical approach, we reduced the risks related to dissection and brain retraction. Moreover, in both cases, neuroendoscopy enabled us to identify an initial, precocious subependymal tumor spreading below the threshold of magnetic resonance imaging (MRI detection. This finding, undetected in pre-operative MRI scans, was then evident during follow-up neuroimaging studies. In light of these data, a neuroendoscopic approach might play a leading role in better defining the prognosis and optimally tailored management protocols for GBM and brain metastasis.Keywords: subependymal spreading, glioblastoma, brain metastasis, endoscopy, minimally invasive surgery, prognosis

  9. A Phase I trial of dose escalation of topotecan combined with whole brain radiotherapy for brain metastasis in lung cancer

    Institute of Scientific and Technical Information of China (English)

    Xiaohui Ge; Wenyan Zhao; Xiaocang Ren; Yongqiang Wang; Zhigang Li; Yanqi Li; Yuee Liu; Qiang Lin

    2012-01-01

    Objective: The aim of this study was to define the maximum-tolerated dose (MTD) and observe the toxicity of escalating topotecan combined whole brain radiotherapy for brain metastasis in lung cancer. Methods: Patients with brain metastasis of lung cancer received conventional fractionation radiotherapy, with 5 daily fractions of 2 Gy per week, the total radiation dose was 40 Gy, while the larger lesions were boosted to 50-60 Gy. The initial dose of topotecan was 1.0 mg/m2. Escalation dose was 0.25 mg/m2. Every cohort contained at least 3 patients.If no dose-limiting toxicity (DLT) was observed,the next dose level was opened for entry. These courses were repeated until DLT appeared. MTD was declared as one dose level below which DLT appeared. Results: Eighteen patients were recruited. Two cases of grade 3 leucopenia/neutropenia was observed as DLT at the level of topotecan 2.0 mg/m2. MTD of topotecan was defined as 1.75 mg/m2.The major side effects were leucopenia/neutropenia, nausea and vomiting. Conclusion: Topotecan combined with whole brain radiotherapy for brain metastasis in lung cancer is well tolerated. Maximum-tolerated dose of topotecan is 1.75 mg/m2, once a week of a total of four.

  10. Intracranial metastasis from primary transitional cell carcinoma of female urethra: case report & review of the literature

    International Nuclear Information System (INIS)

    Transitional cell carcinoma (TCC) of the female urethra is a rare urological malignancy, and intracranial metastasis of this cancer has not yet been reported in the literature. This review is intended to present a case of multiple intracranial metastasis in a female patient with a remote history of primary urethral TCC. A 49-year-old woman, presented with a prolapsed mass in urethral orifice that was diagnosed as primary urethral TCC with distant lung and multiple bone metastases. The patient subsequently underwent chemotherapy under various regimens. A year later, the patient developed headache and vomiting which as was found to be due to multiple intracranial metastasis. The patient underwent surgical resection of the largest lesion located on the cerebellum, and consecutively gamma knife radiosurgery was performed for other small-sized lesions. Pathological examination of the resected mass revealed a metastatic carcinoma from a known urethral TCC. Serial work-up of systemic metastasis revealed concomitant aggravation of lung, spleen, and liver metastasis. The patient died of lung complication 2 months after the diagnosis of brain metastasis. To the best of our knowledge, this is the first reported case of cerebral metastasis from primary urethral TCC, with pathological confirmation. As shown in intracranial metastasis of other urinary tract carcinoma, this case occurred in the setting of uncontrolled systemic disease and led to dismal prognosis in spite of aggressive interventional modalities

  11. The impact of repeat stereotactic radiosurgery on the management of brain metastasis with maintaining brain function

    International Nuclear Information System (INIS)

    We investigated the utility of repeat stereotactic radiosurgery (RSRS), assisted with a careful monitoring by MRI, in the management of brain metastases. Thirty-seven patients harboring brain metastasis received RSRS. RSRS at the same site was performed in 14. The cumulative 5-year survival rate was 29% and the median survival time was 32 months. Cause of death was as follows: 14 uncontrolled extracranial disease and 2 progressed brain metastases. There were no severe adverse events. For 16 patients, neurocognitive function was examined and the most recent results revealed that 88% was not associated with impaired neurocognition. RSRS appears a preferred option to manage brain metastases with maintaining brain function. (author)

  12. Late Bilateral Renal Metastasis of Choriocarcinoma: A Case Report

    Directory of Open Access Journals (Sweden)

    M. Tahmasebi

    2008-01-01

    Full Text Available Introduction: Late bilateral renal metastasis of chori-ocarcinoma is a rare condition. Herein we report a case of late renal metastasis of choriocarcinoma."nCase Presentation: A 28 years old woman presented with gross hematuria since three months ago. A mo-bile palpable mass in her right flank was detected. She was not pregnant but had a history of abortion at six weeks of gestation in seven years age. Her gyneco-logic examination was normal. She had severe anemia (Hb=7.2, elevated ESR (52 with normal renal and liver function testes. Ultrasonography showed bilat-eral large kidney masses by solid-cystic components, with predominant solid parts. Bilateral lobulated het-erogeneous renal masses were found at non-enhancing axial CT-Scan, with notable enhancement of solid parts after administration of contrast agent. Angiography revealed bilateral hypovascular renal masses. Right radical nephrectomy performed for the patient and pathology reported choriocarcinoma of kidney. Finally, she was referred for chemotherapy of contralateral renal mass, but she delayed that for three months. She died following a seizure attack and cardiopulmonary arrest without response to prompt cardio-pulmonary resuscitation. Autopsy not permit-ted by relevants. "nConclusion: Late metastases of choriocarcinoma may appear in kidney or brain after a long time following the primary source of malignancy, when the primary lesion has disappeared.

  13. Leptomeningeal metastasis from hepatocellular carcinoma with other unusual metastases: a case report

    International Nuclear Information System (INIS)

    Leptomeningeal metastasis, which results from metastasis of tumors to the arachnoid and pia mater, can lead to the dissemination of tumor cells throughout the subarachnoid space via the cerebral spinal fluid, and frequently with a poor prognosis. The primary tumor in adults is most often breast cancer, lung cancer, or melanoma. Although leptomeningeal metastasis due to cholangiocarcinoma has been reported, to the best of our knowledge there is no cytologically confirmed report of leptomeningeal metastasis from hepatocellular carcinoma. We herein report a case of leptomeningeal metastasis from hepatocellular carcinoma in a 53-year-old woman with concomitant systemic metastases to the lung, bone, brain, kidney, adrenal gland, subcutaneous tissues, and abdominal pelvis. The neurological symptoms of the patient were relieved after treatment with methotrexate intra-cerebral spinal fluid chemotherapy concurrent with whole brain radiotherapy. To our knowledge this is the first report of leptomeningeal metastasis from hepatocellular carcinoma confirmed by cytology. Treatment with methotrexate intra-cerebral spinal fluid chemotherapy concurrent with whole brain radiotherapy was effective

  14. A Case of Sphenoid Sinus Metastasis in Hepatocellular Carcinoma.

    Science.gov (United States)

    Lee, Tae Hoon; Rangan, Vikram; Khallafi, Hicham

    2016-06-01

    Sphenoid sinus metastasis from hepatocellular carcinoma (HCC) has been reported only rarely. We present a case of solitary sphenoid sinus metastasis of a 2.7 × 2.3 cm single HCC lesion. (Hepatology 2016;63:2050-2053). PMID:26928869

  15. Solitary Metastasis of Gastric Cancer to Fibula: A Case Report

    International Nuclear Information System (INIS)

    Gastric cancer is one of the most common and most fatal neoplasms in human. Its skeletal metastasis is less frequent, particularly when solitary. The objective of this article is to represent a case of solitary fibular metastasis from this cancer not reported before based on Medline search

  16. Serpins Promote Cancer Cell Survival and Vascular Cooption in Brain Metastasis

    OpenAIRE

    Valiente, Manuel; Obenauf, Anna C.; Jin, Xin; Chen, Qing; Zhang, Xiang H.-F.; Lee, Derek J.; Chaft, Jamie E.; Kris, Mark G.; Huse, Jason T.; Brogi, Edi; Massagué, Joan

    2014-01-01

    Brain metastasis is an ominous complication of cancer, yet most cancer cells that infiltrate the brain die of unknown causes. Here we identify plasmin from the reactive brain stroma as a defense against metastatic invasion, and plasminogen activator (PA) inhibitory serpins in cancer cells as a shield against this defense. Plasmin suppresses brain metastasis in two ways: by converting membrane-bound astrocytic FasL into a paracrine death signal for cancer cells, and by inactivating the axon pa...

  17. Gamma knife surgery for brain metastasis from hepatocellular carcinoma.

    Directory of Open Access Journals (Sweden)

    Qingsheng Xu

    Full Text Available OBJECTIVES: The authors evaluated the results of Gamma knife surgery (GKS for the treatment of metastatic brain tumors from hepatocellular carcinoma (HCC. METHODS AND RESULTS: The authors conducted a retrospective review of the clinical characteristics and treatment outcomes in 14 patients with metastatic brain tumors from HCC who underwent GKS. Twelve (85.7% patients were male. The mean age of the patients was 53±12 years. There were totally 22 brain metastases in 14 patients and 8 patients (57.1% presented with a single brain lesion. Intracranial hemorrhages occurred in 13 (59.1% of the 22 lesions. The mean KPS score was 81±14 (range 50-100. Eleven (78.6% patients were classified as RTOG RPA Class 2. The mean tumor volume was 8.16±8.15 cm(3 (range 0.59-27.0 cm(3. The mean marginal dose prescribed was 18.7±3.2 Gy (range 10.0-22.0 Gy. The mean number of shots administered was 10±9 (range 1-27. The median overall survival time after GKS was 5.0±0.93 months (95% CI 3.2-6.8. No complications related to the radiosurgical treatment were identified. Multivariate analysis showed that the total volume of brain metastases, the RTOG RPA class and serum AFP level were significantly correlated with patients' survival time. CONCLUSIONS: Although survival was extremely poor in patients with brain metastasis (BM from HCC, GKS was shown to lead to prolongation of the survival time. Accordingly, GKS can be considered as a valuable treatment option for proper patients with HCC BM.

  18. Choroid Melanoma Metastasis to Spine: A Rare Case Report

    Directory of Open Access Journals (Sweden)

    Hiren Mandaliya

    2016-01-01

    Full Text Available Metastatic choroid melanoma is a highly malignant disease with a limited life expectancy. The liver is the most common site for metastasis of uveal melanoma followed by lung, bone, skin, and subcutaneous tissue. Metastasis from choroidal melanoma usually occurs within the first five years of treatment for primary tumours. Metastatic choroid melanoma to the spine/vertebrae is extremely rare. We report the first case of spinal metastasis from choroid melanoma in a 61-year-old man who had been treated for primary ocular melanoma three years earlier with radioactive plaque brachytherapy. Synchronously, at the time of metastasis, he was also diagnosed as having a new primary lung adenocarcinoma as well. The only other case reported on vertebral metastasis from malignant melanoma of choroid in literature in which primary choroid melanoma was enucleated.

  19. Risk factors for brain metastasis in small-cell lung cancer after surgery

    International Nuclear Information System (INIS)

    Objective: To evaluate clinical risk factors that can predict brain metastasis after complete resection of small cell lung cancer (SCLC) and to assess the role of prophylactic cranial irradiation (PCI) in such kind of patients. Methods: Eighty-eight patients with completely resected stage I - III SCLC from Jan. 2000 to Dec. 2009 in our hospital were retrospectively analyzed. Kaplan-Meier was used to compare the differences in the incidence of metastasis free survival in different groups. Logistic model was used to assess the independent risk factors for brain metastasis. Results: The follow-up rate is 100%, and 37 patients were followed up for more than three years. None of the 3 patients who received PCI developed brain metastasis, while for patients without receiving PCI, 24% developed brain metastases. The incidence of brain metastasis for stage I, II and III SCLC after surgery were 4%, 26% and 29% (χ2 =7.57, P =0.023), respectively. The median survival time and the 3-year survival rate were 18 months and 25% for patients who developed brain metastasis, and 48 months and 59% for those without brain metastasis (χ2 =10.63, P =0.001). Both univariate and multivariate analyses showed that pre-treatment disease stage was independent risk factor for brain metastasis (χ2 =7.57, 8.52; P =0.023, 0.004). Age, sex, tumor location, pathological type, induction chemotherapy, and postoperative chemotherapy/radiotherapy were not significantly correlated with the incidence of brain metastasis (χ2 =0.03, 0.00, 0.00, 2.58, 0.01, 1.23, 0.84; P =0.869, 0.998, 0.992, 0.109, 0.936, 0.266, 0.361, respectively). Conclusions: Pre-treatment disease stage was independent risk factor for brain metastasis in SCLC. PCI may be important for stage II -III SCLC but not for stage I disease. (authors)

  20. Whole brain radiation therapy in management of brain metastasis: results and prognostic factors

    International Nuclear Information System (INIS)

    To evaluate the prognostic factors associated with overall survival in patients with brain metastasis treated with whole brain radiotherapy (WBRT) and estimate the potential improvement in survival for patients with brain metastases, stratified by the Radiation Therapy Oncology Group (RTOG) recursive partitioning analysis (RPA) class. From January 1996 to December 2000, 270 medical records of patients with diagnosis of brain metastasis, who received WBRT in the Hospital do Cancer Sao Paulo A.C. Camargo in the period, were analyzed. The surgery followed by WBRT was used in 15% of patients and 85 % of others patients were submitted at WBRT alone; in this cohort 134 patients (50%) received the fractionation schedule of 30 Gy in 10 fractions. The most common primary tumor type was breast (33%) followed by lung (29%), and solitary brain metastasis was present in 38.1% of patients. The prognostic factors evaluated for overall survival were: gender, age, Karnofsky Performance Status (KPS), number of lesions, localization of lesions, primary tumor site, surgery, chemotherapy, absence extracranial disease, RPA class and radiation doses and fractionation. The OS in 1, 2 and 3 years was 25, 1%, 10, 4% e 4, 3% respectively, and the median survival time was 4.6 months. The median survival time in months according to RPA class after WBRT was: 6.2 class I, 4.2 class II and 3.0 class III (p < 0.0001). In univariate analysis, the significant prognostic factors associated with better survival were: KPS higher than 70 (p < 0.0001), neurosurgery (p < 0.0001) and solitary brain metastasis (p = 0.009). In multivariate analysis, KPS higher than 70 (p < 0.001) and neurosurgery (p = 0.001) maintained positively associated with the survival. In this series, the patients with higher perform status, RPA class I, and treated with surgery followed by whole brain radiotherapy had better survival. This data suggest that patients with cancer and a single metastasis to the brain may be treated

  1. Efficacy of XELOX plus Bevacizumab in Brain Metastasis from Rectal Cancer

    Directory of Open Access Journals (Sweden)

    Yoichiro Yoshida

    2014-02-01

    Full Text Available Brain metastasis (BM is rare in colorectal cancer (CRC patients. Although BM from CRC is a late-stage phenomenon with an extremely poor prognosis, some subsets of patients would benefit from a multidisciplinary management strategy. The prognosis of patients with BM from CRC was associated with the curability of the therapy for BM and the number of metastatic organs. Metastatic brain tumors are generally treated with radiotherapy because many anticancer drugs cannot cross the blood-brain barrier. Here, we present a case treated with XELOX (capecitabine and oxaliplatin plus bevacizumab for BM from rectal cancer. To our knowledge, this is the first report of a patient who was successfully treated for BM from CRC without radiotherapy. The findings could lead to a paradigm shift in the use of chemotherapy for BM from CRC.

  2. Differentiation of local tumor recurrence from radiation-induced changes after stereotactic radiosurgery for treatment of brain metastasis: case report and review of the literature

    OpenAIRE

    Kickingereder, Philipp; Dorn, Franziska; Blau, Tobias; Schmidt, M.; Kocher, Martin; Galldiks, Norbert; Ruge, Maximilian I.

    2013-01-01

    Background Structural follow-up magnetic resonance imaging (MRI) after stereotactic radiosurgery (SRS) for brain metastases frequently displays local changes in the area of applied irradiation, which are often difficult to interpret (e.g., local tumor recurrence, radiation-induced changes). The use of stereotactic biopsy for histological assessment of these changes has a high diagnostic accuracy and can be considered as method of choice. In order to solve this relevant clinical problem non-in...

  3. Surgical Treatment for Non-small Cell Lung Cancer Patients with Synchronous Solitary Brain Metastasis

    OpenAIRE

    Bai, Hao; Han, Baohui

    2013-01-01

    Background and objective Brain metastases are common in non-small cell lung cancer. Usual treatments include radiotherapy and chemotherapy. However, these methods result in poor patient prognosis. The aim of this study is to assess the effectiveness of surgical resection in the multimodality management of non-small cell lung cancer patients with synchronous solitary brain metastasis. Methods The clinical data of 46 non-small cell lung cancer patients with synchronous solitary brain metastasis...

  4. Gestational Choriocarcinoma Presenting with Lacrimal Gland Metastasis: A First Reported Case

    Directory of Open Access Journals (Sweden)

    Naushad A. B. Ahamed

    2015-01-01

    Full Text Available Background. Gestational choriocarcinoma (GC is a recognized clinicopathological subtype of gestational trophoblastic neoplasia that usually metastasizes hematogenously to highly vascular organs like the lung, liver, and brain. However, orbital metastasis to the choroid and lacrimal gland is a rare occurrence. Case Presentation. A 21-year-old female presented with headache and left orbital swelling one year after resection of a complete hydatidiform mole followed by adjuvant methotrexate chemotherapy. A metastatic imaging screening revealed multiple metastases in the lungs, brain, and adrenal gland, in addition to the choroid and lacrimal gland. Based on her modified WHO risk factors scoring she was started on chemotherapy and whole brain radiotherapy, which resulted in a complete response. At two-year follow-up, serum b-HCG level was with normal limits; imaging surveillance was uneventful. Conclusion. We present the first case of lacrimal gland metastasis in a young girl from GC relapse.

  5. A Case of Conjunctival Melanoma Presenting with Breast Metastasis

    Directory of Open Access Journals (Sweden)

    Mustafa Canhoroz

    2014-03-01

    Full Text Available Most breast masses arise from the breast. Metastasis to the breast is fairly uncommon, but can occur in breast skin and parenchyma. In particular, leukemia and lung cancers, and MM may metastasize to the breast. Breast metastasis might be the first symptom or may occur during the course of other malignancies. Our case presented with a fixed mass in the upper-medial quadrant of her left breast during regular follow-up visits. The mean time to breast metastasis in patients with MM is 62 months (13-178. In our case this time was 48 months. In a case series with 7 patients hematological malignancies (Hodgkin lymphoma, non-Hodgkin lymphoma, and leukemia were the leading cause of breast metastasis, whereas in only 1 case the cause was MM. In another case series of 15 MM patients with metastasis to the breast, the primary tumor was frequently localized to the upper extremities and trunk. In a report of 250 conjunctival MM cases the mortality rate was significantly higher in patients with tumors >4 mm in vertical thickness. In another 45-case MM series tumors with a diameter >10 mm were associated with higher mortality rates. In our case the thickness of the tumor was 5 mm. In conclusion, histopathological evaluation should be mandatory in patients with known primary malignancies in order to differentiate new primary tumors, metastases, and benign tumors.

  6. Stereotactic irradiation without whole-brain irradiation for single brain metastasis

    International Nuclear Information System (INIS)

    Purpose: The effectiveness of stereotactic irradiation (STI) alone without whole-brain irradiation (WBI) for a single metastatic brain tumor was analyzed retrospectively. Methods and Materials: Forty-four patients with this condition were treated using radiosurgery (RS) alone or fractionated stereotactic radiotherapy (FSR) without WBI. Results: The initial response rate was 92% and the overall local control rate was 84% (37 of 44 patients). A total of 39% (18 of 44) of patients experienced intracranial relapse outside the initial target area. Forty-eight percent (21 of 44) of patients required salvage treatment for intracranial relapse. All 7 patients who received WBI as salvage treatment required no further salvage treatment, but 5 of the 14 patients who received salvage STI without WBI required three to four treatments for brain metastasis. Late radiation damage was not seen with initial treatment but was observed with retreatment. The overall median survival time was 261 days, with a standard error of 64 days. Actuarial survival at 12 and 24 months was 34% and 9%, respectively. The actuarial survival rate was significantly affected by the existence of active extracranial disease (p = 0.041). Conclusion: The high response rate and short treatment period of STI alone are advantageous in the treatment of single brain metastasis in patients with active extracranial disease with WBI reserved for relapse. Because of the low complication rate, STI alone may be also useful in patients with good prognosis, without extracranial disease

  7. The Effectiveness of Bevacizumab in Radionecrosis After Radiosurgery of a Single Brain Metastasis

    Science.gov (United States)

    Ursino, Stefano; Pasqualetti, Francesco; Pesaresi, Ilaria; Desideri, Ilaria; Cosottini, Mirco; Laliscia, Concetta; Paiar, Fabiola; Fabrini, Maria Grazia

    2015-01-01

    Radionecrosis (RN) of brain tissue is a serious late complication of brain irradiation and historically has been treated with corticos-teroid therapy and alternatively surgical decompression. Recently, bevacizumab has been suggested for treatment of cerebral radiation necrosis. We present a case of a 73-years-old women affected by a primary non-small cell lung cancer with a single brain metastasis treated with radiosurgery. Two years after radiosurgery the patient referred neurological symptoms and a brain magnetic resonance confirmed the presence of RN. The patient refused surgical decompression so underwent at the treatment with bevacizumab 7.5 mg/kg/2 weeks for a total of 4 cycles. After two months of treatment the patient reported strumental and clinical improvement. Ten months after bevacizumab discontinuation the patient experienced a recurrence of RN with evident clinical manifestation and confirmed by radiological imaging. A new treatment with bevacizumab was not performed due to the systemic progression disease and the worsening of clinical status. Despite limited to only one clinical case, our study suggests the efficacy of bevacizumab to treat RN. Future studies are needed to confirm its mechanism and to properly define the optimal scheduling, dosage and duration of therapy. PMID:26788278

  8. The effectiveness of bevacizumab in radionecrosis after radiosurgery of a single brain metastasis

    Directory of Open Access Journals (Sweden)

    Durim Delishaj

    2015-12-01

    Full Text Available Radionecrosis (RN of brain tissue is a serious late complication of brain irradiation and historically has been treated with corticosteroid therapy and alternatively surgical decompression. Recently, bevacizumab has been suggested for treatment of cerebral radiation necrosis. We present a case of a 73-years-old women affected by a primary non-small cell lung cancer with a single brain metastasis treated with radiosurgery. Two years after radiosurgery the patient referred neurological symptoms and a brain magnetic resonance confirmed the presence of RN. The patient refused surgical decompression so underwent at the treatment with bevacizumab 7.5 mg/kg/2 weeks for a total of 4 cycles. After two months of treatment the patient reported strumental and clinical improvement. Ten months after bevacizumab discontinuation the patient experienced a recurrence of RN with evident clinical manifestation and confirmed by radiological imaging. A new treatment with bevacizumab was not performed due to the systemic progression disease and the worsening of clinical status. Despite limited to only one clinical case, our study suggests the efficacy of bevacizumab to treat RN. Future studies are needed to confirm its mechanism and to properly define the optimal scheduling, dosage and duration of therapy.

  9. CXCR4/CXCL12 in Non-Small-Cell Lung Cancer Metastasis to the Brain

    OpenAIRE

    Sebastiano Cavallaro

    2013-01-01

    Lung cancer represents the leading cause of cancer-related mortality throughout the world. Patients die of local progression, disseminated disease, or both. At least one third of the people with lung cancer develop brain metastases at some point during their disease, even often before the diagnosis of lung cancer is made. The high rate of brain metastasis makes lung cancer the most common type of tumor to spread to the brain. It is critical to understand the biologic basis of brain metastases...

  10. Ureteral Metastasis Secondary to Prostate Cancer: A Case Report.

    Science.gov (United States)

    Morales, I; Bassa, C; Pavlovic, A; Morales, C

    2016-03-01

    Prostate cancer is very frequent, but secondary ureteral metastasis are extremely rare. We present a 55 year old man with a 2 month history of right flank pain and lower urinary tract symptoms. Prostatic specific antigen of 11.3 ng/mL. Computed tomography showed right hydroureteronephrosis, a developing urinoma and right iliac adenopathies. He underwent right ureteronephrectomy, iliac lymphadenectomy and prostate biopsy. Pathology revealed prostatic carcinoma infiltrating the ureteral muscularis propria, without mucosal involvement. There are 46 reported cases of prostate cancer with ureteral metastases. Ureteral metastasis are a rare cause of renal colic and need of a high index of suspicion. PMID:26793587

  11. Ureteral Metastasis Secondary to Prostate Cancer: A Case Report

    Directory of Open Access Journals (Sweden)

    I. Morales

    2016-03-01

    Full Text Available Prostate cancer is very frequent, but secondary ureteral metastasis are extremely rare. We present a 55 year old man with a 2 month history of right flank pain and lower urinary tract symptoms. Prostatic specific antigen of 11.3 ng/mL. Computed tomography showed right hydroureteronephrosis, a developing urinoma and right iliac adenopathies. He underwent right ureteronephrectomy, iliac lymphadenectomy and prostate biopsy. Pathology revealed prostatic carcinoma infiltrating the ureteral muscularis propria, without mucosal involvement. There are 46 reported cases of prostate cancer with ureteral metastases. Ureteral metastasis are a rare cause of renal colic and need of a high index of suspicion.

  12. The factors that have an impact on the development of brain metastasis in the patients with breast cancer

    OpenAIRE

    Adem Dayan; Dogan Koca; Tulay Akman; Ilhan Oztop; Hulya Ellidokuz; Ugur Yilmaz

    2012-01-01

    Background: To evaluate the factors that have an impact on the development of brain metastasis in patients with breast cancer. Materials and Methods: Among the patients who were followed-up and treated for breast cancer between January 2000 and January 2010, the ones with brain metastasis were included to the analysis. Metastatic breast cancer patients without brain metastasis, which had similar duration of follow-up and median age were included as the control group. Both group were compa...

  13. Gamma-knife radiosurgery for brain metastasis of renal cell carcinoma. Results in 42 patients

    International Nuclear Information System (INIS)

    The present study provides data from clinical experience with gamma-knife radiosurgery (GK) in patients with brain metastasis from renal cell carcinoma (RCC) and shows the value of this less invasive treatment modality. Forty-two patients received GK. Twenty of the 42 cases had multiple brain metastases. Extracranial metastases were observed in the lung (38 cases), bone (12 cases), liver (9 cases), lymph node (5 cases) and skin (6 cases). Neurological symptoms seen in 40 patients were rapidly improved after GK in 32 patients (80%). Magnetic resonance imaging (MRI) evaluation after GK in 32 patients showed the disappearance of brain tumor in 9 patients (28%). Complete response was obtained by GK in tumors up to 30 mm in diameter. Repeated GK for newly developed lesions was conducted in 11 patients. Extracranial tumor resection was conducted in 7 cases (lung: 3, skin: 2, liver: 1, adrenal: 1). Chemoradiotherapy or immunotherapy was effective in 8 cases (lung: 5, liver: 2, bone: 1). The actual one-, two- and three-year survival rates were 44.9%, 16.8%, and 11.2%, respectively. The median survival time was 12.5 months. In univariate analysis, the patients with successfully treated extracranial metastases had significantly better prognosis. In multivariate analysis, the patients with Karnofsky performance scale (KPS)≥80%, who were treated by GK more than once and obtained complete response (CR) or partial response (PR) by GK, had significantly better prognosis. Gamma-knife radiosurgery for RCC is an effective non-invasive modality of treatment. It offers a high local control rate and an improved quality of life and survival rate. (author)

  14. The metastatic microenvironment: Claudin-1 suppresses the malignant phenotype of melanoma brain metastasis.

    Science.gov (United States)

    Izraely, Sivan; Sagi-Assif, Orit; Klein, Anat; Meshel, Tsipi; Ben-Menachem, Shlomit; Zaritsky, Assaf; Ehrlich, Marcelo; Prieto, Victor G; Bar-Eli, Menashe; Pirker, Christine; Berger, Walter; Nahmias, Clara; Couraud, Pierre-Olivier; Hoon, Dave S B; Witz, Isaac P

    2015-03-15

    Brain metastases occur frequently in melanoma patients with advanced disease whereby the prognosis is dismal. The underlying mechanisms of melanoma brain metastasis development are not well understood. Identification of molecular determinants regulating melanoma brain metastasis would advance the development of prevention and therapy strategies for this disease. Gene expression profiles of cutaneous and brain-metastasizing melanoma variants from three xenograft tumor models established in our laboratory revealed that expression of tight junction component CLDN1 was lower in the brain-metastasizing variants than in cutaneous variants from the same melanoma. The objective of our study was to determine the significance of CLDN1 downregulation/loss in metastatic melanoma and its role in melanoma brain metastasis. An immunohistochemical analysis of human cells of the melanocyte lineage indicated a significant CLDN1 downregulation in metastatic melanomas. Transduction of melanoma brain metastatic cells expressing low levels of CLDN1 with a CLDN1 retrovirus suppressed their metastatic phenotype. CLDN1-overexpressing melanoma cells expressed a lower ability to migrate and adhere to extracellular matrix, reduced tumor aggressiveness in nude mice and, most importantly, eliminated the formation of micrometastases in the brain. In sharp contrast, the ability of the CLDN1-overexpressing cells to form lung micrometastases was not impaired. CLDN1-mediated interactions between these cells and brain endothelial cells constitute the mechanism underlying these results. Taken together, we demonstrated that downregulation or loss of CLDN1 supports the formation of melanoma brain metastasis, and that CLDN1 expression could be a useful prognostic predictor for melanoma patients with a high risk of brain metastasis. PMID:25046141

  15. Anal metastasis from recurrent breast lobular carcinoma: A case report

    Institute of Scientific and Technical Information of China (English)

    Maria Puglisi; Emanuela Varaldo; Michela Assalino; Gianluca Ansaldo; Giancarlo Torre; Giacomo Borgonovo

    2009-01-01

    We report a case of isolated gastrointestinal metastasis from breast lobular carcinoma, which mimicked primary anal cancer. In July 2000, an 88-year-old woman presented with infiltrating lobular cancer (pT1/G2/N2). The patient received postoperative radiotherapy and hormonal therapy. Four years later,she presented with an anal polypoid lesion. The mass was removed for biopsy. Immunohistochemical staining suggested a breast origin. Radiotherapy was chosen for this patient, which resulted in complete regression of the lesion. The patient died 3 years after the first manifestation of gastrointestinal metastasis.According to the current literature, we consider the immunohistochemistry features that are essential to support the suspicion of gastrointestinal breast metastasis, and since we consider the gastrointestinal involvement as a sign of systemic disease, the therapy should be less aggressive and systemic.

  16. Brain Metastasis in Bone and Soft Tissue Cancers: A Review of Incidence, Interventions, and Outcomes

    Directory of Open Access Journals (Sweden)

    Faris Shweikeh

    2014-01-01

    Full Text Available Bone and soft tissue malignancies account for a small portion of brain metastases. In this review, we characterize their incidence, treatments, and prognosis. Most of the data in the literature is based on case reports and small case series. Less than 5% of brain metastases are from bone and soft tissue sarcomas, occurring most commonly in Ewing’s sarcoma, malignant fibrous tumors, and osteosarcoma. Mean interval from initial cancer diagnosis to brain metastasis is in the range of 20–30 months, with most being detected before 24 months (osteosarcoma, Ewing sarcoma, chordoma, angiosarcoma, and rhabdomyosarcoma, some at 24–36 months (malignant fibrous tumors, malignant peripheral nerve sheath tumors, and alveolar soft part sarcoma, and a few after 36 months (chondrosarcoma and liposarcoma. Overall mean survival ranges between 7 and 16 months, with the majority surviving < 12 months (Ewing’s sarcoma, liposarcoma, malignant fibrous tumors, malignant peripheral nerve sheath tumors, angiosarcoma and chordomas. Management is heterogeneous involving surgery, radiosurgery, radiotherapy, and chemotherapy. While a survival advantage may exist for those given aggressive treatment involving surgical resection, such patients tended to have a favorable preoperative performance status and minimal systemic disease.

  17. Choroidal metastasis from tubulopapillary renal cell carcinoma: a case report

    OpenAIRE

    Elghissassi, Ibrahim; Inrhaoun, Hanane; Ismaili, Nabil; Errihani, Hassan

    2009-01-01

    Choroidal metastases from renal carcinoma are rare. Most reported cases describe a clear cell carcinoma histologic subtype. Metastatic tubulopapillary renal cell carcinoma to the choroid plexus is very exceptional. We report the case of a 31-year-old man with a history of tubulopapillary renal cell carcinoma who presented two years later with metastatic disease to lungs and presternal soft tissue and three months after with choroidal metastasis revealed on ophtalmoscopic examination and magne...

  18. Spinal metastasis of medulloblastoma in adults: A case report

    OpenAIRE

    Živković Nenad; Berisavac Iva; Marković Marko; Milenković Sanja

    2014-01-01

    Introduction. Medulloblastoma is a primitive neuro-ectodermal malignant tumor most commonly seen in childhood and rarely and uncommonly in adult age. Treatment consists of surgery followed by radiotherapy. In the case of a relapse there is no overall accepted treatment. Tumor metastasis can be seen along the neural axis, lymph nodes, soft tissues, bones and distant organs. Case Outline. In this paper we present a 45-year-old female patient with a thoraco-sp...

  19. Renal cell carcinoma presenting as a solitary cutaneous facial metastasis: case report and review of the literature

    OpenAIRE

    Porter, Neil A; Anderson, Helen L; Al-Dujaily, Saad

    2006-01-01

    Background Renal cell carcinoma is well known for its frequency to metastasise, particularly to lungs, liver, bones and brain. Metastasis to the skin is much less common. Presentation as a result of the skin lesion is even more unusual, with only 14 previously reported cases in the English literature. The majority of these cases have been reported in patients with recurrent disease or with other metastases. Case presentation We present only the second case of non-recurrent renal cell carcinom...

  20. Adenocarcinoma of urethra presenting metastasis to eyes: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Lages, Rafael Bandeira; Sousa, Rodrigo Beserra; Santos, Lina Gomes dos; Vieira, Sabas Carlos, E-mail: rafaelblages@gmail.co [Universidade Federal do Piaui (UFPI), Teresina, PI (Brazil); Tavares, Marilia Buenos Aires Cabral [Universidade Federal do Ceara (UFC), Fortaleza, CE (Brazil). Hospital Universitario Walter Cantidio; Valenca, Rodrigo Jose de Vasconcelos [Hospital Sao Marcos (HSM), Teresina, PI (Brazil)

    2010-07-01

    Primary urethral carcinoma is extremely rare, accounting for less than 1% of all female genitourinary tract cancers. To the best of our knowledge, this patient is the first reported case of primary urethral carcinoma presenting metastasis to eyes. The diagnosis of metastasis involving the choroids should be suspected in patient with history of carcinoma and a decreased visual acuity or any other visual symptom. Case presentation: A 43-year-old woman underwent a total hysterectomy, cystectomy and bilateral pelvic lymphadenectomy due a primary adenocarcinoma of the proximal urethra. Adjuvant pelvic radiotherapy and six cycles of chemotherapy using cisplatin were performed. The patient made follow-up with no evidence of oncologic disease. However, nine months later, the patient reported visual alterations. Ophthalmoloscopic examination showed choroid lesions in both eyes that were compatible with metastatic choroids tumor and nuclear magnetic resonance suggested bilateral retinal metastasis and left meningioma parasagittal in parietal region. She was undergoing a new palliative chemotherapy, but the disease developed and there were metastasis to bone four months later. The patient died fourteen months after the surgery. (author)

  1. Sternal metastasis as an initial presentation of renal cell carcinoma: a case report

    OpenAIRE

    Batista, Raquel Ribeiro; Marchiori, Edson; Takayassu, Tatiana Chinem; Cabral, Fernanda Caseira; Cabral, Rafael Ferracini; Zanetti, Gláucia

    2009-01-01

    Renal cell carcinoma accounts for 85% of all solid renal tumors in adults. Nearly one quarter of patients has distant metastasis at presentation while another 50% develop metastasis during follow-up. A small percentage of these are solitary metastasis. We report here a case of solitary bone sternal metastasis as an initial presentation of clear-cell renal cell carcinoma in a 56-year-old woman. The prognosis for patients with metastasized renal cell carcinoma is poor; treatment of metastasis i...

  2. Gain of glucose-independent growth upon metastasis of breast cancer cells to the brain

    OpenAIRE

    Chen, Jinyu; Lee, Ho-Jeong; Wu, Xuefeng; Huo, Lei; Kim, Sun-Jin; Xu, Lei; Wang, Yan; He, Junqing; Bollu, Lakshmi Reddy; Gao, Guang; Su, Fei; Briggs, James; Liu, Xiaojing; Melman, Tamar; Asara, John M.

    2014-01-01

    Breast cancer brain metastasis is resistant to therapy and a particularly poor prognostic feature in patient survival. Altered metabolism is a common feature of cancer cells but little is known as to what metabolic changes benefit breast cancer brain metastases. We found that brain-metastatic breast cancer cells evolved the ability to survive and proliferate independent of glucose due to enhanced gluconeogenesis and oxidations of glutamine and branched chain amino acids, which together sustai...

  3. Selective permeabilization of the blood-brain barrier at sites of metastasis

    OpenAIRE

    Sibson, NR; Vallis, KA; Hamilton, A.; Seymour, L.; Anthony, DC; Connell, JJ; Chatain, G

    2013-01-01

    BACKGROUND: Effective chemotherapeutics for primary systemic tumors have limited access to brain metastases because of the blood-brain barrier (BBB). The aim of this study was to develop a strategy for specifically permeabilizing the BBB at sites of cerebral metastases. METHODS: BALB/c mice were injected intracardially to induce brain metastases. After metastasis induction, either tumor necrosis factor (TNF) or lymphotoxin (LT) was administered intravenously, and 2 to 24 hours later gadoliniu...

  4. Whole brain radiotherapy with adjuvant or concomitant boost in brain metastasis: dosimetric comparison between helical and volumetric IMRT technique

    International Nuclear Information System (INIS)

    To compare and evaluate the possible advantages related to the use of VMAT and helical IMRT and two different modalities of boost delivering, adjuvant stereotactic boost (SRS) or simultaneous integrated boost (SIB), in the treatment of brain metastasis (BM) in RPA classes I-II patients. Ten patients were treated with helical IMRT, 5 of them with SRS after whole brain radiotherapy (WBRT) and 5 with SIB. MRI co-registration with planning CT was mandatory and prescribed doses were 30 Gy in 10 fractions (fr) for WBRT and 15Gy/1fr or 45Gy/10fr in SRS or SIB, respectively. For each patient, 4 “treatment plans” (VMAT SRS and SIB, helical IMRT SRS and SIB) were calculated and accepted if PTV boost was included in 95 % isodose and dose constraints of the main organs at risk were respected without major deviations. Homogeneity Index (HI), Conformal Index (CI) and Conformal Number (CN) were considered to compare the different plans. Moreover, time of treatment delivery was calculated and considered in the analysis. Volume of brain metastasis ranged between 1.43 and 51.01 cc (mean 12.89 ± 6.37 ml) and 3 patients had double lesions. V95% resulted over 95 % in the average for each kind of technique, but the “target coverage” was inadequate for VMAT planning with two sites. The HI resulted close to the ideal value of zero in all cases; VMAT-SIB, VMAT-SRS, Helical IMRT-SIB and Helical IMRT-SRS showed mean CI of 2.15, 2.10, 2.44 and 1.66, respectively (optimal range: 1.5–2.0). Helical IMRT-SRS was related to the best and reliable finding of CN (0.66). The mean of treatment time was 210 s, 467 s, 440 s, 1598 s, respectively, for VMAT-SIB, VMAT-SRS, Helical IMRT-SIB and Helical IMRT-SRS. This dosimetric comparison show that helical IMRT obtain better target coverage and respect of CI and CN; VMAT could be acceptable in solitary metastasis. SIB modality can be considered as a good choice for clinical and logistic compliance; literature’s preliminary data are confirming

  5. Brain metastasis from differentiated thyroid cancer in patients treated with radioiodine for bone and lung lesions

    International Nuclear Information System (INIS)

    Brain metastasis of differentiated thyroid cancer (DTC) often is detected during treatment of other remote lesions. We examined the prevalence, risk factors and treatment outcome of this disease encountered during nuclear medicine practice. Of the 167 patients with metastasis to lung or bone treated 1-14 times with radioactive iodine (RAI), 9 (5.4%) also had lesions in the brain. Five were males and 4 females, aged 49-84, out of the original population of 49 males and 118 females aged 10-84 (mean 54.7) years. Three of them underwent removal of their brain tumors, 5 received conventional external beam irradiation, and 2 had stereotactic radiosurgery with supervoltage X-ray. None of the brain lesions showed significant uptake of RAI despite demonstrable accumulation in most extracerebral lesions. Seven patients died 4-23 (mean 9.4) months after the discovery of cerebral metastasis, brain damage being the primary or at least a contributing cause. The 8th and 9th patients remained relatively well for more than 42 and 3 months, respectively, without any evidence of intracranial recurrence. Our results confirmed that the brain is a major site of secondary metastasis from DTC. No statistically significant demographic risk factor was detected. Any suspicious neurological symptoms in the course of RAI treatment warrant cerebral computed tomography. As for therapy, from out initial experience, radiosurgery seemed promising as an effective and less invasive alternative to surgical removal. (author)

  6. Choroidal metastasis from early rectal cancer: Case report and literature review

    OpenAIRE

    Mitsuyoshi Tei; Masaki Wakasugi; Hiroki Akamatsu

    2014-01-01

    INTRODUCTION: Choroidal metastasis from colorectal cancer is rare, and there have been no reported cases of such metastasis from early colorectal cancer. We report a case of choroidal metastasis from early rectal cancer. PRESENTATION OF CASE: A 61 year-old-man experienced myodesopsia in the left eye 2 years and 6 months after primary rectal surgery for early cancer, and was diagnosed with left choroidal metastasis and multiple lung metastases. Radiotherapy was initiated for the left eye an...

  7. A rare case of thyroid metastasis from pancreatic adenocarcinoma.

    LENUS (Irish Health Repository)

    Kelly, Michael E

    2012-02-01

    CONTEXT: Thyroid metastasis from pancreatic adenocarcinoma is extremely rare, with only two previous cases in the literature. We report a case of pancreatic adenocarcinoma metastasising to the thyroid. We review the incidence, diagnosis, and management of this rare occurrence. CASE REPORT: A 38-year-old man with a synchronous 6-month history of thyroid swelling, presented with epigastric pain and signs of obstructive jaundice. He was investigated by abdominal computerised tomography and endoscopic retrograde cholangiopancreatography. The diagnosis of pancreatic neoplasm was made. His thyroid neoplasm was investigated at another tertiary centre and thought to be a papillary neoplasm. He underwent a pancreaticoduodenectomy and recovered well post-operatively. Eight weeks later he had a total thyroidectomy. Histology confirmed that the thyroid mass was both morphologically and immunophenotypically similar to the pancreatic neoplasm. CONCLUSION: This case demonstrates the importance of a full investigation when a patient with suspected neoplastic history presents with a thyroid nodule. We outline the crucial role that immunohistochemistry plays in detecting and classifying primary and secondary thyroid neoplasms. The detection of a solitary thyroid metastasis from pancreatic adenocarcinoma may indicate a poor prognosis, and it is debatable whether resection of the primary should be undertaken when it presents with a solitary metastasis.

  8. [Targeted Therapy and Immunotherapy for Non-small Cell Lung Cancer 
with Brain Metastasis].

    Science.gov (United States)

    Song, Qi; Jiao, Shunchang; Li, Fang

    2016-08-20

    Brain metastasis, a common complication of non-small cell lung cancer (NSCLC) with an incidence rate of 30%-50%, significantly affects the patients' quality of life. The prognosis of patients of NSCLC with brain metastasis is extremely poor, the average median survival is only 1 m-2 m without treatment. The targeted therapy based on lung cancer driven gene is a new treatment. Besides, the immunotherapy which can enhance the effect of anti-cancer by simulating the immune system is a new approach. The combination of targeted therapy and immunotherapy can greatly benefit patients in clinical work. PMID:27561803

  9. The factors that have an impact on the development of brain metastasis in the patients with breast cancer

    Directory of Open Access Journals (Sweden)

    Adem Dayan

    2012-01-01

    Conclusions: As the prognostic and predictive factors showing the development of brain metastasis in breast cancer patients may be identified, follow-up also including the brain is important in order to take preventive measures.

  10. Spinal metastasis of medulloblastoma in adults: A case report

    Directory of Open Access Journals (Sweden)

    Živković Nenad

    2014-01-01

    Full Text Available Introduction. Medulloblastoma is a primitive neuro-ectodermal malignant tumor most commonly seen in childhood and rarely and uncommonly in adult age. Treatment consists of surgery followed by radiotherapy. In the case of a relapse there is no overall accepted treatment. Tumor metastasis can be seen along the neural axis, lymph nodes, soft tissues, bones and distant organs. Case Outline. In this paper we present a 45-year-old female patient with a thoraco-spinal extramedullary metastatic medulloblastoma and progressive neurological deterioration seen 11 months after the first operation and description of magnetic resonance and intraoperative finding. Conclusion. Although rare, the presence of metastasis is a poor prognostic factor. The treatment options for patients with metastases are limited and their prognosis continues to remain poor.

  11. Tumor necrosis factor receptor superfamily member 9 is upregulated in the endothelium and tumor cells in melanoma brain metastasis

    Directory of Open Access Journals (Sweden)

    Patrick N Harter

    2014-12-01

    Full Text Available Aim: The cytokine receptor tumor necrosis factor receptor superfamily member 9 (TNFRSF9 is mainly considered to be a co-stimulatory activation marker in hematopoietic cells. Several preclinical models have shown a dramatic beneficial effect of treatment approaches targeting TNFRSF9 with agonistic antibodies. However, preliminary clinical phase I/II studies were stopped after the occurrence of several severe deleterious side effects. In a previous study, it was demonstrated that TNFRSF9 was strongly expressed by reactive astrocytes in primary central nervous system (CNS tumors, but was largely absent from tumor or inflammatory cells. The aim of the present study was to address the cellular source of TNFRSF9 expression in the setting of human melanoma brain metastasis, a highly immunogenic tumor with a prominent tropism to the CNS. Methods: Melanoma brain metastasis was analyzed in a cohort of 78 patients by immunohistochemistry for TNFRSF9 and its expression was correlated with clinicopathological parameters including sex, age, survival, tumor size, number of tumor spots, and BRAF V600E expression status. Results: Tumor necrosis factor receptor superfamily member 9 was frequently expressed independently on both melanoma and endothelial cells. In addition, TNFRSF9 was also present on smooth muscle cells of larger vessels and on a subset of lymphomonocytic tumor infiltrates. No association between TNFRSF9 expression and patient survival or other clinicopathological parameters was seen. Of note, several cases showed a gradual increase in TNFRSF9 expression on tumor cells with increasing distance from blood vessels, an observation that might be linked to hypoxia-driven TNFRSF9 expression in tumor cells. Conclusion: The findings indicate that the cellular source of TNFRSF9 in melanoma brain metastasis largely exceeds the lymphomonocytic pool, and therefore further careful (re- assessment of potential TNFRSF9 functions in cell types other than

  12. Isolated splenic metastasis from colon cancer: Case report

    OpenAIRE

    Abdou, Jiddou; Omor, Youssef; Boutayeb, Saber; Elkhannoussi, Basma; Errihani, Hassan

    2016-01-01

    Isolated splenic metastases from colorectal cancer are very rare clinical entities and when they are present, they usually manifest widely disseminated disease. In this paper we report a case of metachronous solitary isolated splenic metastasis from colon cancer in a 64-year-old woman who was successfully treated by laparoscopic splenectomy. We discuss the pathological and clinical aspects of this condition. We furthermore comment on the diagnostic and therapeutic options of this rare entity ...

  13. A Case of Esophageal Squamous Cell Carcinoma with Pancreatic Metastasis

    OpenAIRE

    Park, Choulki; Jang, Jae Young; Kim, Youn Hwa; Hwang, Eun Jung; Na, Ki Yong; Kim, Kyung-Yup; Park, Jae Hyun; Chang, Young Woon

    2013-01-01

    Solitary pancreatic metastasis of esophageal cancer is extremely rare. We report the case of a 58-year-old male admitted with esophageal cancer. Additional asymptomatic solitary hepatic and pancreatic masses were observed in the staging work-up for esophageal cancer. The hepatic mass was confirmed as a primary hepatocellular carcinoma with an ultrasound-guided needle biopsy. An esophagectomy with a distal pancreatectomy and radiofrequency ablation for hepatocellular carcinoma were performed. ...

  14. A case of unusual metastasis of melanoma of conjunctiva

    Directory of Open Access Journals (Sweden)

    A.M. Andreychenko

    2013-03-01

    Full Text Available ABSTRACT This article describes a clinical case of melanoma of conjunctiva of the upper eyelid of a woman born in 1911. The patient had received a course of external radiotherapy of the primary tumor and plaque brachytherapy tumor recurrences (at 1 and 6 years from the start of treatment. However, after 7 years from the start of treatment, against the background of local remission, the patient had conjunctival melanoma metastasis was found in the choroid of the contralateral eye.

  15. Thyroid gland metastasis arising from breast cancer: A case report

    OpenAIRE

    Yang, Mei; WANG, WEI; ZHANG, CHENFANG

    2013-01-01

    The thyroid gland is an uncommon site for metastasis to develop and thus metastases arising from breast cancer are rarely observed. In the present study, we describe a case of a 45-year-old female with a three-year history of breast cancer who presented with a thyroid mass that was diagnosed as metastatic breast carcinoma by histopathological analysis of the subtotal thyroidectomy specimen. To ascertain the diagnosis of metastatic breast cancer, we evaluated two types of markers; those that p...

  16. Nasopharyngeal carcinoma metastasis to the mammary gland: A case report

    OpenAIRE

    LI, Shuang; Yang, Jiyuan

    2014-01-01

    Nasopharyngeal carcinoma is the second most common type of malignancy in Southern China. Metastatic sites are usually multifocal and involve the bones, lungs and distant lymph nodes. To date, there have been no studies with regard to nasopharyngeal carcinoma metastasis to the mammary gland. In the current study, the case of a 56-year-old female with nasal obstruction, epitaxis and a bilateral neck mass is presented. Following a series of examinations, the patient was diagnosed with nasopharyn...

  17. Occipital lymph node metastasis from nasopharyngeal carcinoma:a special case report and literature review

    Institute of Scientific and Technical Information of China (English)

    Jing Yang; Wei-Xiong Xia; Yan-Qun Xiang; Xing Lv; Liang-Ru Ke; Ya-Hui Yu; Xiang Guo

    2016-01-01

    Cervical lymph node metastasis is common in patients with nasopharyngeal carcinoma (NPC), but occipital lymph node metastasis in NPC patients has not yet been reported. In this case report, we describe an NPC patient with occipital lymph node metastasis. The clinical presentation, diagnostic procedure, treatment, and outcome of this case were presented, with a review of the related literature.

  18. Focalized external radiotherapy for resected solitary brain metastasis: does the dogma stand?

    International Nuclear Information System (INIS)

    Purpose: To investigate whether whole brain irradiation might be replaced by focalized irradiation after resection of a single brain metastasis in patients where extracranial tumor control is deemed to be obtained. Patients and methods: Twelve patients were introduced in a phase I/II prospective study of conformal postoperative external irradiation after resection of a solitary brain metastasis. The radiation treatment consisted of 50.4 Gy (1.8 Gy per fraction, five fractions per week). The planning target volume consisted of the tumor bed and a 2 cm safety margin. All treatments were optimized with head immobilization, dedicated tomodensitometry and computer assisted three-dimensional treatment planning. Results: The median survival was 7.2 months (range 2.4-50.4 months). Eleven of the 12 patients died. Eight of the 12 patients presented intracranial recurrence and seven died as a consequence of intracranial tumor progression. Conclusions: Focalized external irradiation cannot serve as a reasonable alternative to whole brain radiotherapy (WBRT) even for patients with apparently one single resected brain metastasis. The dogma of 'one metastasis=multiple metastases' seems to be confirmed. (Copyright (c) 1998 Elsevier Science B.V., Amsterdam. All rights reserved.)

  19. Control of the blood-brain barrier function in cancer cell metastasis.

    Science.gov (United States)

    Blecharz, Kinga G; Colla, Ruben; Rohde, Veit; Vajkoczy, Peter

    2015-10-01

    Cerebral metastases are the most common brain neoplasms seen clinically in the adults and comprise more than half of all brain tumours. Actual treatment options for brain metastases that include surgical resection, radiotherapy and chemotherapy are rarely curative, although palliative treatment improves survival and life quality of patients carrying brain-metastatic tumours. Chemotherapy in particular has also shown limited or no activity in brain metastasis of most tumour types. Many chemotherapeutic agents used systemically do not cross the blood-brain barrier (BBB), whereas others may transiently weaken the BBB and allow extravasation of tumour cells from the circulation into the brain parenchyma. Increasing evidence points out that the interaction between the BBB and tumour cells plays a key role for implantation and growth of brain metastases in the central nervous system. The BBB, as the tightest endothelial barrier, prevents both early detection and treatment by creating a privileged microenvironment. Therefore, as observed in several in vivo studies, precise targetting the BBB by a specific transient opening of the structure making it permeable for therapeutic compounds, might potentially help to overcome this difficult clinical problem. Moreover, a better understanding of the molecular features of the BBB, its interrelation with metastatic tumour cells and the elucidation of cellular mechanisms responsible for establishing cerebral metastasis must be clearly outlined in order to promote treatment modalities that particularly involve chemotherapy. This in turn would substantially expand the survival and quality of life of patients with brain metastasis, and potentially increase the remission rate. Therefore, the focus of this review is to summarise the current knowledge on the role and function of the BBB in cancer metastasis. PMID:26032862

  20. Clinical Analysis for Brain Tumor-Related Epilepsy during Chemotherapy for Systemic Cancer with Single Brain Metastasis

    OpenAIRE

    Kim, Young Zoon; Lee, Eun Hee; Lee, Kyoung Soo

    2011-01-01

    Purpose The purpose of this prospective observational study was to determine the incidence, patterns, and predisposing factors for brain tumor-related epilepsy (BTRE) during chemotherapy for systemic cancer with single brain metastasis (BM). Materials and Methods Between February 2006 and June 2010, 103 patients who underwent chemotherapy for systemic cancer with single BM were enrolled. We compared the clinical factors of patients and BM between patients with and without BTRE. We determined ...

  1. Cardiac metastasis from colorectal cancer: A case report

    Institute of Scientific and Technical Information of China (English)

    Pyong Wha Choi; Chul Nam Kim; Sun Hee Chang; Woo Ik Chang; Chang Young Kim; Hyun Min Choi

    2009-01-01

    The heart is an unusual site of metastasis from any malignancy. We report a case of cardiac metastasis from colorectal cancer. A 70-year-old woman was referred with a presumptive diagnosis of sigmoid colon cancer with cardiac myxoma. Two-dimensional echocardiography showed a 4 cm × 4.5 cm mobile mass on the lateral right atrial wall, and computed tomography revealed a low attenuated lobulating mass in the right atrium. The patient underwent anterior resection for sigmoid colon cancer (T4N2). Thereafter, she experienced progressive shortness of breath. Therefore, a cardiac operation was performed 2 wk after the colorectal operation.Histological examination revealed adenocarcinoma,which was identical to the primary lesion. Although twodimensional echocardiography has become the diagnostic test of choice for detecting cardiac tumors, in patients with colorectal cancer showing a cardiac mass, further diagnostic evaluation such as a magnetic resonance imaging might be necessary.

  2. Brain metastasis. Prognostic value of the number of involved extracranial organs

    Energy Technology Data Exchange (ETDEWEB)

    Rades, D. [Luebeck Univ. (Germany). Dept. of Radiation Oncology; Gerdan, L. [Luebeck Univ. (Germany). Dept. of Radiation Oncology; Luebeck Univ. (Germany). Section of Nuclear Medicine; Segedin, B. [Institute of Oncology, Ljubljana (Slovenia). Dept. of Radiation Oncology; Nagy, V. [Oncology Institute Ion Ciricuta, Cluj-Napoca (Romania). Dept. of Radiotherapy; Khoa, M.T. [Hanoi Medical Univ., Hanoi (Viet Nam). Dept. of Nuclear Medicine; Bach Mai Hospital, Hanoi (Viet Nam). Nuclear Medicine and Oncology Center; Trang, N.T. [Bach Mai Hospital, Hanoi (Viet Nam). Nuclear Medicine and Oncology Center; Schild, S.E. [Mayo Clinic, Scottsdale, AZ (United States). Dept. of Radiation Oncology

    2013-12-15

    Background and purpose: This study was performed to evaluate the prognostic role for survival of the number and the type of involved extracranial organs in patients with brain metastasis. Material and methods: The data of 1146 patients who received whole-brain radiotherapy (WBRT) alone for brain metastasis have been retrospectively analyzed. In addition to the number of involved extra cranial organs, seven potential prognostic factors were investigated including WBRT regimen, age, gender, Karnofsky Performance Score (KPS), primary tumor type, number of brain metastases, and the interval from cancer diagnosis to WBRT. Additionally, subgroup analyses were performed for patients with involvement of one (lung vs. bone vs. liver vs. other metastasis) and two (lung + lymph nodes vs. lung + bone vs. lung + liver vs. liver + bone vs. other combinations) extracranial organs. Results: The 6-month survival rates for the involvement of 0, 1, 2, 3, and {>=} 4 extracranial organs were 51, 30, 16, 13, and 10 %, respectively (p < 0.001). On multivariate analysis, the number of involved extracranial organs maintained significance (risk ratio 1.26; 95 % confidence interval 1.18-1.34; p < 0.001). According to the multivariate analysis, age (p < 0.001), gender (p = 0.002), and KPS (p < 0.001) were also independent prognostic factors for survival. In the subgroup analyses of patients with involvement of one and two extracranial organs, survival was not significantly different based on the extracranial organ involved. Conclusion: The number of involved extracranial organs proved to be an independent prognostic factor in patients with brain metastasis, regardless of the organs involved. The number of involved extracranial organs should be considered in future trials designed for patients with brain metastasis. (orig.)

  3. MicroRNA and protein profiling of brain metastasis competent cell-derived exosomes.

    Directory of Open Access Journals (Sweden)

    Laura Camacho

    Full Text Available Exosomes are small membrane vesicles released by most cell types including tumor cells. The intercellular exchange of proteins and genetic material via exosomes is a potentially effective approach for cell-to-cell communication and it may perform multiple functions aiding to tumor survival and metastasis. We investigated microRNA and protein profiles of brain metastatic (BM versus non-brain metastatic (non-BM cell-derived exosomes. We studied the cargo of exosomes isolated from brain-tropic 70W, MDA-MB-231BR, and circulating tumor cell brain metastasis-selected markers (CTC1BMSM variants, and compared them with parental non-BM MeWo, MDA-MB-231P and CTC1P cells, respectively. By performing microRNA PCR array we identified one up-regulated (miR-210 and two down-regulated miRNAs (miR-19a and miR-29c in BM versus non-BM exosomes. Second, we analyzed the proteomic content of cells and exosomes isolated from these six cell lines, and detected high expression of proteins implicated in cell communication, cell cycle, and in key cancer invasion and metastasis pathways. Third, we show that BM cell-derived exosomes can be internalized by non-BM cells and that they effectively transport their cargo into cells, resulting in increased cell adhesive and invasive potencies. These results provide a strong rationale for additional investigations of exosomal proteins and miRNAs towards more profound understandings of exosome roles in brain metastasis biogenesis, and for the discovery and application of non-invasive biomarkers for new therapies combating brain metastasis.

  4. Brain metastasis. Prognostic value of the number of involved extracranial organs

    International Nuclear Information System (INIS)

    Background and purpose: This study was performed to evaluate the prognostic role for survival of the number and the type of involved extracranial organs in patients with brain metastasis. Material and methods: The data of 1146 patients who received whole-brain radiotherapy (WBRT) alone for brain metastasis have been retrospectively analyzed. In addition to the number of involved extra cranial organs, seven potential prognostic factors were investigated including WBRT regimen, age, gender, Karnofsky Performance Score (KPS), primary tumor type, number of brain metastases, and the interval from cancer diagnosis to WBRT. Additionally, subgroup analyses were performed for patients with involvement of one (lung vs. bone vs. liver vs. other metastasis) and two (lung + lymph nodes vs. lung + bone vs. lung + liver vs. liver + bone vs. other combinations) extracranial organs. Results: The 6-month survival rates for the involvement of 0, 1, 2, 3, and ≥ 4 extracranial organs were 51, 30, 16, 13, and 10 %, respectively (p < 0.001). On multivariate analysis, the number of involved extracranial organs maintained significance (risk ratio 1.26; 95 % confidence interval 1.18-1.34; p < 0.001). According to the multivariate analysis, age (p < 0.001), gender (p = 0.002), and KPS (p < 0.001) were also independent prognostic factors for survival. In the subgroup analyses of patients with involvement of one and two extracranial organs, survival was not significantly different based on the extracranial organ involved. Conclusion: The number of involved extracranial organs proved to be an independent prognostic factor in patients with brain metastasis, regardless of the organs involved. The number of involved extracranial organs should be considered in future trials designed for patients with brain metastasis. (orig.)

  5. Prognostic predictors for non-small cell lung cancer patients with brain metastasis after radiotherapy

    Directory of Open Access Journals (Sweden)

    Qiuhong FAN

    2008-06-01

    Full Text Available Background and objective Brain metastasis (BM is often found in the patients with lung cancer. Radiotherapy is regular and effective means of therapy and it aims at palliating symptoms and prolonging survival time. However, now there are different viewpoints on protocols of radiotherapy and prognostic factors. A retrospective analysis is used to evaluate the results of treatment for 82 cases with brain metastasis from non-small cell lung cancer (NSCLC and explore the prognostic factors to establish a prognostic index (PI model. Methods From Feb.1995 to Oct. 2006, 82 patients irradiated for BM from NSCLC, with both complete medical charts and follow-up data available, were eligible for this retrospective analysis. A number of potential factors which might affect prognosis after irradiation were evaluated. The significance of prognostic variables in the survival resulted from both univariate analysis by Kaplan-Meier combining with log-rank test and multivariate Cox regression model. The prognostic index (PI was established based on Cox regression analysis and subgrouping values. Results The follow-up time was 1-120 months. For the entire cohort, the median survival from the start of radiation for BM was 10.5 months, and the actuarial overall survival rate was 50.8%, 23.7% and 5.1% at 0.5, 1 and 2 years respectively. Univariate analysis showed KPS, control of primary tumor, interval from the beginning of diagnostic to BM, extracranial systemic metastasis, counts of lymphocyte and solitary BM were predictors of prognosis. However, in the Cox multivariate analysis, only KPS, control of primary tumor, interval from the beginning of diagnostic to BM and solitary BM were significant prognostic factors. The prognostic index was established based on Cox regression analysis and 82 patients were stratified good, intermediate and poor prognostic sub-groups. The difference of survival rate among 3 subgroups is significant (P<0.001. Conclusion Radiotherapy is

  6. Gamma Knife Surgery for Brain Metastasis from Hepatocellular Carcinoma

    OpenAIRE

    Qingsheng Xu; Pan Wu; Yiping Feng; Ke Ye; Ying Tong; Yongqing Zhou

    2014-01-01

    OBJECTIVES: The authors evaluated the results of Gamma knife surgery (GKS) for the treatment of metastatic brain tumors from hepatocellular carcinoma (HCC). METHODS AND RESULTS: The authors conducted a retrospective review of the clinical characteristics and treatment outcomes in 14 patients with metastatic brain tumors from HCC who underwent GKS. Twelve (85.7%) patients were male. The mean age of the patients was 53±12 years. There were totally 22 brain metastases in 14 patients and 8 patien...

  7. Pituitary metastasis of lung neuroendocrine carcinoma: case report and literature review.

    Science.gov (United States)

    de Siqueira, Pedro Freire; Mathez, Andréia Latanza Gomes; Pedretti, Denize Borges; Abucham, Julio

    2015-12-01

    Metastasis to the pituitary gland is an unusual situation in clinical practice, but the frequency thereof is increasing due to the increased survival of cancer patients, and greater availability of imaging. In most cases, they are found between the sixth and seventh decades of life, as determined in image examination of patients with known malignant neoplasm, but, generally, asymptomatic with respect to pituitary involvement. The most common primary sites are breast in women and lung in men. We present the case of a 64-year-old patient with clinical visual changes, polyuria, polydipsia, and decreased level of consciousness whose tests showed pan-hypopituitarism, hypernatremia and low urine specific gravity, and extensive mass in sellar region. Diabetes insipidus was confirmed and treated, corticotrophic and thyroid deficits were corrected and then the patient underwent resection by transsphenoidal surgery. The histopathological and immunohistochemistry analysis revealed pituitary metastasis of lung neuroendocrine tumor. Subsequently, a chest CT scan showed pulmonary mass consistent with primary neoplasm. Despite the water and electrolyte correction and intravenous glucocorticoid replacement, the patient continued to show decreased level of consciousness due to compression of the brain stem by the pituitary mass, evolving to death. The purpose is to call attention to the differential diagnosis of invasive lesions of the sellar region, mainly in individuals over 50 years and/or when associated with diabetes insipidus, as it may be a case of metastasis, although there is no known primary neoplasm. PMID:26677090

  8. Unique Case Report of Pineal Gland Metastasis From Bladder Carcinoma

    OpenAIRE

    Li, Jun; Wang, Ping; Wang, Bin

    2016-01-01

    Abstract Pineal metastasis is uncommon and most metastatic pineal lesions are asymptomatic. To our knowledge the herein reported case is the first in which the pineal gland was confirmed as the metastatic site of a bladder carcinoma. The patient reported in this case is a 59-year-old man who suffered from headache and delirium for 4 days after surgical treatment for removal of a bladder carcinoma 1 year ago. Magnetic resonance imaging (MRI) revealed a solid tumor involving the pineal gland wi...

  9. The fibrinolytic system facilitates tumor cell migration across the blood-brain barrier in experimental melanoma brain metastasis

    International Nuclear Information System (INIS)

    Patients with metastatic tumors to the brain have a very poor prognosis. Increased metastatic potential has been associated with the fibrinolytic system. We investigated the role of the fibrinolytic enzyme plasmin in tumor cell migration across brain endothelial cells and growth of brain metastases in an experimental metastatic melanoma model. Metastatic tumors to the brain were established by direct injection into the striatum or by intracarotid injection of B16F10 mouse melanoma cells in C57Bl mice. The role of plasminogen in the ability of human melanoma cells to cross a human blood-brain barrier model was studied on a transwell system. Wild type mice treated with the plasmin inhibitor epsilon-aminocaproic acid (EACA) and plg-/- mice developed smaller tumors and survived longer than untreated wild type mice. Tumors metastasized to the brain of wild type mice treated with EACA and plg-/- less efficiently than in untreated wild type mice. No difference was observed in the tumor growth in any of the three groups of mice. Human melanoma cells were able to cross the human blood-brain barrier model in a plasmin dependent manner. Plasmin facilitates the development of tumor metastasis to the brain. Inhibition of the fibrinolytic system could be considered as means to prevent tumor metastasis to the brain

  10. Role of KCNMA1 gene in breast cancer invasion and metastasis to brain

    International Nuclear Information System (INIS)

    The prognosis for patients with breast tumor metastases to brain is extremely poor. Identification of prognostic molecular markers of the metastatic process is critical for designing therapeutic modalities for reducing the occurrence of metastasis. Although ubiquitously present in most human organs, large-conductance calcium- and voltage-activated potassium channel (BKCa) channels are significantly upregulated in breast cancer cells. In this study we investigated the role of KCNMA1 gene that encodes for the pore-forming α-subunit of BKCa channels in breast cancer metastasis and invasion. We performed Global exon array to study the expression of KCNMA1 in metastatic breast cancer to brain, compared its expression in primary breast cancer and breast cancers metastatic to other organs, and validated the findings by RT-PCR. Immunohistochemistry was performed to study the expression and localization of BKCa channel protein in primary and metastatic breast cancer tissues and breast cancer cell lines. We performed matrigel invasion, transendothelial migration and membrane potential assays in established lines of normal breast cells (MCF-10A), non-metastatic breast cancer (MCF-7), non-brain metastatic breast cancer cells (MDA-MB-231), and brain-specific metastatic breast cancer cells (MDA-MB-361) to study whether BKCa channel inhibition attenuates breast tumor invasion and metastasis using KCNMA1 knockdown with siRNA and biochemical inhibition with Iberiotoxin (IBTX). The Global exon array and RT-PCR showed higher KCNMA1 expression in metastatic breast cancer in brain compared to metastatic breast cancers in other organs. Our results clearly show that metastatic breast cancer cells exhibit increased BKCa channel activity, leading to greater invasiveness and transendothelial migration, both of which could be attenuated by blocking KCNMA1. Determining the relative abundance of BKCa channel expression in breast cancer metastatic to brain and the mechanism of its action in

  11. Role of KCNMA1 gene in breast cancer invasion and metastasis to brain

    Directory of Open Access Journals (Sweden)

    Couraud Pierre-Olivier

    2009-07-01

    Full Text Available Abstract Background The prognosis for patients with breast tumor metastases to brain is extremely poor. Identification of prognostic molecular markers of the metastatic process is critical for designing therapeutic modalities for reducing the occurrence of metastasis. Although ubiquitously present in most human organs, large-conductance calcium- and voltage-activated potassium channel (BKCa channels are significantly upregulated in breast cancer cells. In this study we investigated the role of KCNMA1 gene that encodes for the pore-forming α-subunit of BKCa channels in breast cancer metastasis and invasion. Methods We performed Global exon array to study the expression of KCNMA1 in metastatic breast cancer to brain, compared its expression in primary breast cancer and breast cancers metastatic to other organs, and validated the findings by RT-PCR. Immunohistochemistry was performed to study the expression and localization of BKCa channel protein in primary and metastatic breast cancer tissues and breast cancer cell lines. We performed matrigel invasion, transendothelial migration and membrane potential assays in established lines of normal breast cells (MCF-10A, non-metastatic breast cancer (MCF-7, non-brain metastatic breast cancer cells (MDA-MB-231, and brain-specific metastatic breast cancer cells (MDA-MB-361 to study whether BKCa channel inhibition attenuates breast tumor invasion and metastasis using KCNMA1 knockdown with siRNA and biochemical inhibition with Iberiotoxin (IBTX. Results The Global exon array and RT-PCR showed higher KCNMA1 expression in metastatic breast cancer in brain compared to metastatic breast cancers in other organs. Our results clearly show that metastatic breast cancer cells exhibit increased BKCa channel activity, leading to greater invasiveness and transendothelial migration, both of which could be attenuated by blocking KCNMA1. Conclusion Determining the relative abundance of BKCa channel expression in breast

  12. Brain metastasis: an evaluation of the preoperative diagnostic work-up

    International Nuclear Information System (INIS)

    This is a retrospective study of the evaluation of various preoperative diagnostic tests in locating the primary lesion in 50 patients with a solitary brain lesion seen on computerized tomography and suspected to be metastatic. These patients underwent craniotomy and 54% had primary tumors 40% metastatic tumors and 6.1% non-neoplastic lesions. Of 20 patients with metastasis, the primary was identified in 19 patients with the following locations: 11 pulmonary, 3 breast, 2 thyroid and 2 colon. In 2 patients, no primary was identified. Using simple conditional probability theory, it was established that the probability of a brain metastatic lesion in patients without a previous history of diagnosed non-nervous system cancer, negative chest x-ray, and normal CEA was 14.7%. However, in patients with a previous history of diagnosed non-nervous system cancer, the probability of having a metastatic lesion is high (88%). Extensive testing preoperatively may be justified in these cases because of its value in surgical decision-making and long-term prognosis. (Author)

  13. Intrapancreatic bile duct metastasis from colon cancer after resection of liver metastasis with intrabiliary growth: a case report.

    Science.gov (United States)

    Kawakatsu, Shoji; Kaneoka, Yuji; Maeda, Atsuyuki; Takayama, Yuichi; Fukami, Yasuyuki; Onoe, Shunsuke

    2015-01-01

    An extremely rare case of intrapancreatic bile duct metastasis from sigmoid colon adenocarcinoma is herein presented. Sigmoid colon cancer (T3, N0, M0, stage IIA) had been diagnosed and treated by sigmoidectomy in October 1993. In December 2002, a liver metastasis with intrabiliary growth was found, and this was treated by extended right hepatic lobectomy and caudate lobectomy with extrahepatic bile duct resection. In February 2014, intrapancreatic bile duct metastasis was found, and this was treated by subtotal stomach-preserving pancreatoduodenectomy. The intrapancreatic metastasis was judged to have arisen from cancer cell implantation, either by spontaneous shedding of cancer cells or as a complication of percutaneous transhepatic biliary drainage. Twelve months have passed since the last surgical intervention, and there has been no sign of local recurrence or distant metastasis. Differential diagnosis between intrahepatic cholangiocarcinoma and intrabiliary growth of a liver metastasis originating from colorectal adenocarcinoma is difficult but very important for determining the therapeutic strategy. Careful examination is needed to diagnose intrahepatic biliary dilatation, especially for patients with a history of carcinoma in the digestive tract and even if years have passed since curative resection of the digestive tract cancer. Aggressive surgical management for localized recurrence of a hepatic metastasis from colorectal adenocarcinoma may improve patient survival. PMID:26293132

  14. A case report of neck, chest and upper limb cutaneous metastasis from synchronous colorectal cancer

    Institute of Scientific and Technical Information of China (English)

    WANG Jian; SHI Yu-qian; WU Zhi-yong

    2009-01-01

    Cutaneous metastasis from colorectal carcinoma is uncommon, occurring in less than 4% of the whole patients.' The most frequently involved are incision scar or abdominal skin,24 while cutaneous metastasis to neck and chest is very rare. We hereby report a case of synchronous, postoperative cutaneous metastasis from colorectal carcinoma to neck, upper limb and chest skin, which were confirmed by biopsy.

  15. Neuroendocrine tumors presenting with thyroid gland metastasis: a case series

    Directory of Open Access Journals (Sweden)

    Sivrikoz Emre

    2012-02-01

    Full Text Available Abstract Introduction Autopsy series have shown that metastasis to the thyroid gland has occurred in up to 24% of patients who have died of cancer. Neuroendocrine tumors may metastasize to thyroid gland. Case presentations Case 1 was a 17-year-old Turkish woman who was referred from our Endocrinology Department for a thyroidectomy for treatment of neuroendocrine tumor metastasis. She was treated with a bilateral total thyroidectomy. Histopathological examination results were consistent with a neuroendocrine tumor; neoplastic cells showed strong immunoreactivity to chromogranin A and synaptophysin, but the immunohistochemical profile was inconsistent with medullary thyroid carcinoma in that the tumor was negative for calcitonin, carcinoembryonic antigen, and thyroid transcription factor-1. Case 2 was a 54-year-old Turkish woman who presented with a 3-cm nodule on her right thyroid lobe. She had undergone surgery for a right lung mass four years previously. After a right pneumonectomy, thymectomy and lymph node dissection, a typical carcinoid tumor was diagnosed. Under ultrasonographic guidance, fine needle aspiration biopsy of her right thyroid pole nodule was performed and the biopsy was compatible with a neuroendocrine tumor metastasis. She was treated with a bilateral total thyroidectomy. Histopathological examination indicated three nodular lesions, 5 cm and 0.4 cm in diameter in her right lobe and 0.1 cm in diameter in her left lobe. The tumors were consistent with a neuroendocrine phenotype, showing strong immunoreactivity to chromogranin A and synaptophysin. Conclusion Thyroid nodules detected during follow-up of neuroendocrine tumor patients should be thoroughly investigated. A fine needle aspiration biopsy of the thyroid confirms the diagnosis in most cases and leads to appropriate management of those patients and may prevent unnecessary treatment approaches.

  16. Metachronous Bilateral Isolated Adrenal Metastasis from Rectal Adenocarcinoma: A Case Report

    Directory of Open Access Journals (Sweden)

    H. Jabir

    2014-01-01

    Full Text Available We report a case of adrenal metastasis from colorectal cancer in a 54-year-old woman. Nine months after resection for advanced rectal carcinoma, a computed tomography scan revealed bilateral adrenal metastasis. The level of serum carcinoembryonic antigen was normal. A bilateral adrenalectomy was performed after chemotherapy. Histopathological examination showed adenocarcinoma, compatible with metastasis from the rectal cancer. Adrenal metastasis should be considered in the patients’ follow-up for colorectal cancer.

  17. Thyroid Metastasis in Pyramidal Lobe from Renal Cell Carcinoma: A Case Report

    International Nuclear Information System (INIS)

    Thyroid metastasis is rare. The most common primary malignancy of thyroid metastasis worldwide is known to be renal cell carcinoma, but the most common primary malignancy in South Korea is breast cancer. Many studies have reported that primary renal cell carcinoma is almost unilateral and thyroid metastasis from renal cell carcinoma is a nearly ipsilateral, single lesion. We report a case of pyramidal lobe metastasis from renal cell carcinoma.

  18. An Unusual Case of Gastric Cancer Presenting with Breast Metastasis with Pleomorphic Microcalcifications

    OpenAIRE

    Luk, Yiu Shiobhon; Ka, Solomon Yig Joon; Lo, Sherwin Shing Wai; Chu, Chi Yeung; Ma, Ming Wai

    2012-01-01

    Breast metastasis from gastric carcinoma is rare. We present a case of right breast mass with microcalcification in which the diagnosis of poorly differentiated adenocarcinoma from the stomach was made after a biopsy. Pleomorphic microcalcification was noted in the ill-defined breast mass, which is a rare feature in breast metastasis. Since breast metastasis usually signifies advanced metastatic disease, differentiating primary breast cancer from metastasis is important for appropriate treatm...

  19. Thyroid Metastasis in Pyramidal Lobe from Renal Cell Carcinoma: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Hyung Seok; Kim, Dong Wook; Kim, Sang Su [Dept. of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of); Jung, Soo Jin [Dept. of Pathology, Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

    2011-06-15

    Thyroid metastasis is rare. The most common primary malignancy of thyroid metastasis worldwide is known to be renal cell carcinoma, but the most common primary malignancy in South Korea is breast cancer. Many studies have reported that primary renal cell carcinoma is almost unilateral and thyroid metastasis from renal cell carcinoma is a nearly ipsilateral, single lesion. We report a case of pyramidal lobe metastasis from renal cell carcinoma.

  20. miR-509 suppresses brain metastasis of breast cancer cells by modulating RhoC and TNF α

    OpenAIRE

    Xing, Fei; Sharma, Sambad; Liu, Yin; Mo, Yin-Yuan; Wu, Kerui; Zhang, Ying-Yu; Pochampally, Radhika; Martinez, Luis A.; Lo, Hui-Wen; Watabe, Kounosuke

    2015-01-01

    The median survival time of breast cancer patients with brain metastasis is less than 6 months, and even a small metastatic lesion often causes severe neurological disabilities. Because of the location of metastatic lesions, a surgical approach is limited and most chemotherapeutic drugs are ineffective due to the blood brain barrier (BBB). Despite this clinical importance, the molecular basis of the brain metastasis is poorly understood. In this study, we have isolated RNA from samples obtain...

  1. The evaluation of the radiation therapy of brain metastasis from lung cancer by means of computed tomography

    International Nuclear Information System (INIS)

    We studied the effect of radiation therapy (RT) on 132 patients with brain metastasis from lung cancer between April 1978 and May 1987; evaluation was done by means of computed tomography (CT) scans. The CT findings of brain metastasis had some relationship to the histological types of lung cancer. Besides, the response to RT on CT images correlated with the histological diagnosis and the CT findings, both solid-contrast enhancement (S type) and ring-contrast enhancement (R type), of metastatic lesions. The results were as follows. A shrinkage of the brain metastases following RT was observed in 98.3% for small-cell carcinoma, in 75.0% for adenocarcinoma, and in 72.7% for squamous-cell carcinoma. The S type showed a better response to RT than did the R type, irrespective of their histological type, during RT. During RT, a decrease in tumor size was observed in the S type, while a decrease in the thickness of the ring wall, without any remarkable change in tumor size, was observed in the R type. In cases with small-cell carcinoma and squamous-cell carcinoma, smaller metastatic lesions had greater effects than larger ones. After the completion of RT, a delayed effect was found on the follow-up CT in the cases with adenocarcinoma and squamous-cell carcinoma. Adenocarcinoma in the S type and squamous-cell carcinoma in the R type showed the best delayed effect. (author)

  2. Morphological and functional MRI, MRS, perfusion and diffusion changes after radiosurgery of brain metastasis

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Tae Wook [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710 (Korea, Republic of)], E-mail: tw227.kang@samsung.com; Kim, Sung Tae [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710 (Korea, Republic of)], E-mail: st7.kim@hotmail.com; Byun, Hong Sik [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710 (Korea, Republic of)], E-mail: hongsik5474.byun@samsung.com; Jeon, Pyoung [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710 (Korea, Republic of)], E-mail: pyoung.jeon@samsung.com; Kim, Keonha [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710 (Korea, Republic of)], E-mail: somatom.kim@samsung.com; Kim, Hyungjin [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710 (Korea, Republic of)], E-mail: hyungjin1219.kim@samsung.com; Lee, Jung II [Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710 (Korea, Republic of)], E-mail: jilee.lee@samsung.com

    2009-12-15

    Radiosurgery is a noninvasive procedure where spatially accurate and highly conformal doses of radiation are targeted at brain lesions with an ablative intent. Recently, radiosurgery has been established as an effective technique for local treatment of brain metastasis. After radiosurgery, magnetic resonance (MR) imaging plays an important role in the assessment of the therapeutic response and of any complications. The therapeutic approach depends on the imaging findings obtained after radiosurgery, which have a role in the decision making to perform additional invasive modalities (repeat resection, biopsy) to obtain a definite diagnosis and to improve the survival of patients. Conventional MR imaging findings are mainly based on morphological alterations of tumors. However, there are variable imaging findings of radiation-induced changes including radiation necrosis in the brain. Radiologists are sometimes confused by radiation-induced injuries, including radiation necrosis, that are seen on conventional MR imaging. The pattern of abnormal enhancement on follow-up conventional MR imaging closely mimics that of a recurrent brain metastasis. So, classifying newly developed abnormal enhancing lesions in follow-up of treated brain metastasis with correct diagnosis is one of the key goals in neuro-oncologic imaging. To overcome limitations of the use of morphology-based conventional MR imaging, several physiological-based functional MR imaging methods have been used, namely diffusion-weighted imaging, perfusion MR imaging, and proton MR spectroscopy, for the detection of hemodynamic, metabolic, and cellular alterations. These imaging modalities provide additional information to allow clinicians to make proper decisions regarding patient treatment.

  3. Tumor-targeting Salmonella typhimurium A1-R arrests growth of breast-cancer brain metastasis

    OpenAIRE

    Zhang, Yong; Miwa, Shinji; Zhang, Nan; Hoffman, Robert M.; Zhao, Ming

    2014-01-01

    Brain metastasis is a morbid, treatment-resistant, end-stage frequent occurrence in breast cancer patients. The aim of this study was to evaluate the efficacy of tumor-targeting Salmonella typhimurium A1-R on breast cancer brain metastases. High brain-metastatic variants of murine 4T1 breast cancer cells expressing red fluorescent protein (RFP) were injected orthotopically in the mammary fat pad in non-transgenic nude mice or in the left ventricle of non-transgenic nude mice and transgenic nu...

  4. Ovarian metastasis of malignant melanoma: The first pediatric case

    Directory of Open Access Journals (Sweden)

    Yuko Araki

    2014-10-01

    Full Text Available We report a case of an 8-year-old girl with metastasis of malignant melanoma (MM to the ovary. She was initially diagnosed with cutaneous MM on the left buttock for which she underwent wide local excision, left inguinal/pelvic lymph node dissection, and subcutaneous injection of interferon beta. In spite of the treatment, she developed dissemination of MM to the liver, the bone, and the right ovary. All the lesions responded well to systemic chemotherapy (intravenous dacarbazine, except for the right ovarian tumor. She underwent an elective right salpingo-oophorectomy to avoid torsion or rupture of the tumor. However, she developed metastases to the contralateral ovary with peritoneal dissemination in 4 months. She received home palliative care and died at home 14 months after the last surgery. Ovarian metastasis of MM is a rare form of dissemination, and only 15 adult cases have ever been reported. Our patient is the first pediatric case. Since there is no standard of surgical indication for metastatic MM to the ovary, palliative resection can be an option for improving quality of life of a patient with this rare condition.

  5. Unique Case Report of Pineal Gland Metastasis From Bladder Carcinoma.

    Science.gov (United States)

    Li, Jun; Wang, Ping; Wang, Bin

    2016-05-01

    Pineal metastasis is uncommon and most metastatic pineal lesions are asymptomatic. To our knowledge the herein reported case is the first in which the pineal gland was confirmed as the metastatic site of a bladder carcinoma.The patient reported in this case is a 59-year-old man who suffered from headache and delirium for 4 days after surgical treatment for removal of a bladder carcinoma 1 year ago. Magnetic resonance imaging (MRI) revealed a solid tumor involving the pineal gland with significant enhancement.The patient underwent surgical treatment for removal of the neoplastic lesion in the pineal gland. Histopathological examination confirmed invasion of the pineal gland by metastatic urothelial carcinoma.This case highlighted that the presence of pineal lesions in patient with known malignancy should raise suspicion of metastatic involvement. PMID:27149501

  6. Glioblastoma multiforme versus solitary supratentorial brain metastasis. Differentiation based on morphology and magnetic resonance signal characteristics

    International Nuclear Information System (INIS)

    Purpose: To evaluate the diagnostic potential of a multi-factor analysis of morphometric parameters and magnetic resonance (MR) signal characteristics of a mass and peritumoral area to distinguish solitary supratentorial metastasis from glioblastoma multiforme (GBM). Materials and Methods: MR examinations of 51 patients with histologically proven GBM and 44 with a single supratentorial metastasis were evaluated. A large variety of morphologic criteria and MR signal characteristics in different sequences were analyzed. The data were subjected to logistic regression to investigate their ability to discriminate between GBM and cerebral metastasis. Receiver-operating characteristic (ROC) analysis was used to select an optimal cut-off point for prediction and to assess the predictive value in terms of sensitivity, specificity, and accuracy of the final model. Results: The logistic regression analysis revealed that the ratio of the maximum diameter of the peritumoral area measured on T2-weighted images (d T2) to the maximum diameter of the enhancing mass area (d T1, post-contrast) is the only useful criterion to distinguish single supratentorial brain metastasis from GBM with a lower ratio favoring GBM (accuracy 68 %, sensitivity 84 % and specificity 45 %). The cut-off point for the ratio d T2/d T1 post-contrast was calculated as 2.35. Conclusion: Measurement of maximum diameters of the peritumoral area in relation to the enhancing mass can be evaluated easily in the clinical routine to discriminate GBM from solitary supratentorial metastasis with an accuracy comparable to that of advanced MRI techniques. (orig.)

  7. CXCR4/CXCL12 in Non-Small-Cell Lung Cancer Metastasis to the Brain

    Directory of Open Access Journals (Sweden)

    Sebastiano Cavallaro

    2013-01-01

    Full Text Available Lung cancer represents the leading cause of cancer-related mortality throughout the world. Patients die of local progression, disseminated disease, or both. At least one third of the people with lung cancer develop brain metastases at some point during their disease, even often before the diagnosis of lung cancer is made. The high rate of brain metastasis makes lung cancer the most common type of tumor to spread to the brain. It is critical to understand the biologic basis of brain metastases to develop novel diagnostic and therapeutic approaches. This review will focus on the emerging data supporting the involvement of the chemokine CXCL12 and its receptor CXCR4 in the brain metastatic evolution of non-small-cell lung cancer (NSCLC and the pharmacological tools that may be used to interfere with this signaling axis.

  8. Esophageal Squamous Cell Carcinoma With Pancreatic Metastasis: A Case Report

    Directory of Open Access Journals (Sweden)

    Abbas Alibakhshi

    2011-11-01

    Full Text Available Malignant tumors of pancreas are usually primary neoplasms and pancreatic metastases are rare findings. We are reporting a case of squamous cell carcinoma (SCC of the esophagus with pancreatic metastasis. A 59-year old woman was admitted with chief complaint of abdominal pain and mass. She was a known case of esophageal SCC since 4 years before when she had undergone transthoracic esophagectomy and cervical esophago-gastrostomy. In order to evaluate recent abdominal mass, CT scan was done which revealed septated cystic lesion in the body and the tail of the pancreas. Palliative resection of the tumor was performed and its histological study showed SCC compatible with her previously diagnosed esophageal cancer.

  9. Duodenal metastasis from male breast cancer: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Ferrari Alberto Bruno

    2009-07-01

    Full Text Available Abstract Introduction Breast cancer is the most frequent type of tumor and the second leading cause of death in women. Metastases are present in nearly 60% of cases at the time of diagnosis with the lymph nodes, skeleton, lungs, brain and liver as the most frequent sites of metastases. Gastrointestinal involvement is rare, present in only 10% of all the cases. There is a very low risk of developing breast cancer in men. Case presentation A 68-year-old man, with a past history of ductal breast cancer, presented with duodenal obstruction. Medical treatment was attempted without success, so he underwent surgery with subtotal gastrectomy and resection of the first portion of the duodenum. Histological examination showed a duodenal metastasis originating from the previous carcinoma of the breast. Five months after surgery, the patient is alive and well. Conclusion Gastrointestinal metastases should be considered in patients with a past history of breast cancer. Surgical treatment should be performed in patients who are symptomatic and in good general condition. To our knowledge this is the only case of a gastrointestinal metastasis from breast carcinoma in a man.

  10. [Nursing care for a lung cancer patient with brain metastasis using the family resiliency model].

    Science.gov (United States)

    Tsai, Chia-Yu; Chen, Shu-Chuan; Jhang, Sin-Yuan; Hong, Ming-Ying

    2014-12-01

    This article describes the experience of the author in providing nursing care to a lung cancer patient with brain metastasis who was unable to care for herself. The period of care ran from July 26th to August 7th, 2012. The focus of the article is on the problems of disease adaptation and the coping strategies of the patient and her primary caregivers. The author used the Family Resiliency Model to collect information via physical examination, observation, and interviews. Five major nursing problems were identified in this case: risk of aspiration, self-care deficits, adjustment disorder, caregiver role strain, and family coping ineffectiveness. Based on these problems, the author constructed an individualized care plan to: 1) improve the self-care ability of the patient, 2) enhance the skills of the primary caregiver, 3) recruit the timely assistance of other family members, 4) and reduce the burden of the primary caregiver. The primary goal of this care plan was to promote the quality of life of the patient and her family. PMID:25464963

  11. Pancreatic solitary and synchronous metastasis from breast cancer: a case report and systematic review of controversies in diagnosis and treatment

    OpenAIRE

    Molino, Carlo; Mocerino, Carmela; Braucci, Antonio; Riccardi, Ferdinando; Trunfio, Martino; Carrillo, Giovanna; Vitale, Maria Giuseppa; Cartenì, Giacomo; De Sena, Guido

    2014-01-01

    Background Metastases from breast cancer cause the frequent involvement of lung, bone, liver, and brain, while the occurrence of metastases to the gastrointestinal tract is rare, and more frequently discovered after a primary diagnosis of breast cancer. Solitary pancreatic metastases from breast cancer, without widespread disease, are actually unusual, and only 19 cases have been previously described; truly exceptional is a solitary pancreatic metastasis becoming evident together with the pri...

  12. Natural killer (NK) cells inhibit systemic metastasis of glioblastoma cells and have therapeutic effects against glioblastomas in the brain

    OpenAIRE

    Lee, Se Jeong; Kang, Won Young; Yoon, Yeup; Jin, Ju Youn; Song, Hye Jin; Her, Jung Hyun; Kang, Sang Mi; Hwang, Yu Kyeong; Kang, Kyeong Jin; Joo, Kyeung Min; Nam, Do-Hyun

    2015-01-01

    Background Glioblastoma multiforme (GBM) is characterized by extensive local invasion, which is in contrast with extremely rare systemic metastasis of GBM. Molecular mechanisms inhibiting systemic metastasis of GBM would be a novel therapeutic candidate for GBM in the brain. Methods Patient-derived GBM cells were primarily cultured from surgical samples of GBM patients and were inoculated into the brains of immune deficient BALB/c-nude or NOD-SCID IL2Rgammanull (NSG) mice. Human NK cells were...

  13. SU-E-T-56: Brain Metastasis Treatment Plans for Contrast-Enhanced Synchrotron Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Obeid, L; Adam, J [Grenoble Institut des Neurosciences, La Tronche, Rhone-Alpes (France); Tessier, A [Centre Hospitalier Universitaire, La Tronche, Rhone-Alpes (France); Vautrin, M; Benkebil, M [DOSIsoft, Cachan, Ile de France (France); Sihanath, R [Centre Hospitalier Universitaire, La Tronche, Rhone- Alpes (France)

    2014-06-01

    Purpose: Iodine-enhanced radiotherapy is an innovative treatment combining the selective accumulation of an iodinated contrast agent in brain tumors with irradiations using monochromatic medium energy x-rays. The aim of this study is to compare dynamic stereotactic arc-therapy and iodineenhanced SSRT. Methods: Five patients bearing brain metastasis received a standard helical 3D-scan without iodine. A second scan was acquired 13 min after an 80 g iodine infusion. Two SSRT treatment plans (with/without iodine) were performed for each patient using a dedicated Monte Carlo (MC) treatment planning system (TPS) based on the ISOgray TPS. Ten coplanar beams (6×6 cm2, shaped with collimator) were simulated. MC statistical error objective was less than 5% in the 50% isodose. The dynamic arc-therapy plan was achieved on the Iplan Brainlab TPS. The treatment plan validation criteria were fixed such that 100% of the prescribed dose is delivered at the beam isocentre and the 70% isodose contains the whole target volume. The comparison elements were the 70% isodose volume, the average and maximum doses delivered to organs at risk (OAR): brainstem, optical nerves, chiasma, eyes, skull bone and healthy brain parenchyma. Results: The stereotactic dynamic arc-therapy remains the best technique in terms of dose conformation. Iodine-enhanced SSRT presents similar performances to dynamic arc-therapy with increased brainstem and brain parenchyma sparing. One disadvantage of SSRT is the high dose to the skull bone. Iodine accumulation in metastasis may increase the dose by 20–30%, allowing a normal tissue sparing effect at constant prescribed dose. Treatment without any iodine enhancement (medium-energy stereotactic radiotherapy) is not relevant with degraded HDVs (brain, parenchyma and skull bone) comparing to stereotactic dynamic arc-therapy. Conclusion: Iodine-enhanced SSRT exhibits a good potential for brain metastasis treatment regarding the dose distribution and OAR criteria.

  14. SU-E-T-56: Brain Metastasis Treatment Plans for Contrast-Enhanced Synchrotron Radiation Therapy

    International Nuclear Information System (INIS)

    Purpose: Iodine-enhanced radiotherapy is an innovative treatment combining the selective accumulation of an iodinated contrast agent in brain tumors with irradiations using monochromatic medium energy x-rays. The aim of this study is to compare dynamic stereotactic arc-therapy and iodineenhanced SSRT. Methods: Five patients bearing brain metastasis received a standard helical 3D-scan without iodine. A second scan was acquired 13 min after an 80 g iodine infusion. Two SSRT treatment plans (with/without iodine) were performed for each patient using a dedicated Monte Carlo (MC) treatment planning system (TPS) based on the ISOgray TPS. Ten coplanar beams (6×6 cm2, shaped with collimator) were simulated. MC statistical error objective was less than 5% in the 50% isodose. The dynamic arc-therapy plan was achieved on the Iplan Brainlab TPS. The treatment plan validation criteria were fixed such that 100% of the prescribed dose is delivered at the beam isocentre and the 70% isodose contains the whole target volume. The comparison elements were the 70% isodose volume, the average and maximum doses delivered to organs at risk (OAR): brainstem, optical nerves, chiasma, eyes, skull bone and healthy brain parenchyma. Results: The stereotactic dynamic arc-therapy remains the best technique in terms of dose conformation. Iodine-enhanced SSRT presents similar performances to dynamic arc-therapy with increased brainstem and brain parenchyma sparing. One disadvantage of SSRT is the high dose to the skull bone. Iodine accumulation in metastasis may increase the dose by 20–30%, allowing a normal tissue sparing effect at constant prescribed dose. Treatment without any iodine enhancement (medium-energy stereotactic radiotherapy) is not relevant with degraded HDVs (brain, parenchyma and skull bone) comparing to stereotactic dynamic arc-therapy. Conclusion: Iodine-enhanced SSRT exhibits a good potential for brain metastasis treatment regarding the dose distribution and OAR criteria

  15. Brain metastases of choriocarcinoma: A report on two cases

    Directory of Open Access Journals (Sweden)

    Milenković Vera

    2013-01-01

    Full Text Available Introduction. Gestational trophoblastic diseases (GTD are a spectrum of tumors with a various of biological behavior and potential for metastases. It consists of hydatiform mole, invasive mole, choriocarcinoma and placental site trophoblastic tumor. Choriocarcinoma presents a very aggressive tumor with high malignant potential. Case report. We presented the two cases of choriocarcinoma with brain metastases. The first one was manifested by neurological deterioration as the first sign of metastasis, while the second patient had firstly metrorrhagia and in the further couse neurological disturbances that suggested the presence of brain tumor. In both cases we applied a combined treatment of surgery, chemotherapy and radiation therapy. Both patient survived with high quality of life. Conclusion. A successful outcome of brain metastases of choriocarcinoma was obtained by the use of a combined treatment of surgery, chemotherapy and radiation therapy. In cases of young women with brain metastases, gynecological malignancy should be always considered.

  16. Expression of vascular endothelial growth factor is necessary but not sufficient for production and growth of brain metastasis.

    Science.gov (United States)

    Yano, S; Shinohara, H; Herbst, R S; Kuniyasu, H; Bucana, C D; Ellis, L M; Davis, D W; McConkey, D J; Fidler, I J

    2000-09-01

    We investigated the molecular mechanisms of angiogenesis in experimental brain metastasis. Cells from six different human cancer cell lines (proven to produce visceral metastasis) were injected into the internal carotid artery of nude mice. Colon carcinoma (KM12SM) and lung adenocarcinoma (PC14PE6 and PC14Br) cells produced large, fast-growing parenchymal brain metastases, whereas lung squamous cell carcinoma (H226), renal cell carcinoma (SN12PM6), and melanoma (TXM13) cells produced only a few slow-growing brain metastases. Rapidly progressing brain metastases contained many enlarged blood vessels. The expression of VEGF mRNA and protein by the tumor cells directly correlated with angiogenesis and growth of brain metastasis. Causal evidence for the essential role of VEGF in this process was provided by transfecting PC14PE6 and KM12SM cells with antisense-VEGF165 gene, which significantly decreased the incidence of brain metastasis. In contrast, transfection of H226 human lung squamous carcinoma cells with sense-VEGF121 or sense-VEGF165 neither enhanced nor inhibited formation of brain metastases. Collectively, the results indicate that VEGF expression is necessary but not sufficient for the production of brain metastasis and that the inhibition of VEGF represents an important therapeutic target. PMID:10987313

  17. Up-regulation of microRNA-10b is associated with the development of breast cancer brain metastasis

    OpenAIRE

    Ahmad, Aamir; Sethi, Seema; Chen, Wei; Ali-Fehmi, Rouba; Mittal, Sandeep; Fazlul H. Sarkar

    2014-01-01

    Brain metastases from primary breast cancer are difficult to treat and associated with poor prognosis. Our understanding of the molecular basis for the development of such cancers is sparse. We hypothesized that the pro-metastatic microRNA-10b (miR-10b) plays a role in breast cancer brain metastasis. The study cohort comprised of twenty patients with breast cancer and brain metastasis as well as ten control patients (age, stage, and follow-up matched) with breast cancer without brain metastas...

  18. Nasopharyngeal carcinoma metastasis to the mammary gland: A case report.

    Science.gov (United States)

    Li, Shuang; Yang, Jiyuan

    2015-01-01

    Nasopharyngeal carcinoma is the second most common type of malignancy in Southern China. Metastatic sites are usually multifocal and involve the bones, lungs and distant lymph nodes. To date, there have been no studies with regard to nasopharyngeal carcinoma metastasis to the mammary gland. In the current study, the case of a 56-year-old female with nasal obstruction, epitaxis and a bilateral neck mass is presented. Following a series of examinations, the patient was diagnosed with nasopharyngeal carcinoma (cT3N3M0). Subsequently, the patient received radical radiation therapy. After three months, a mass was identified in the left breast, together with enlargement of multiple lymph nodes in the left axilla. The patient underwent a mastectomy and pathological examination revealed that the breast mass and axillary lymph node tissues were derived from the nasopharynx. To the best of our knowledge, this is the first report of a nasopharyngeal carcinoma that metastasized to the mammary gland. PMID:25435974

  19. Identification and analysis of signaling networks potentially involved in breast carcinoma metastasis to the brain.

    Directory of Open Access Journals (Sweden)

    Feng Li

    Full Text Available Brain is a common site of breast cancer metastasis associated with significant neurologic morbidity, decreased quality of life, and greatly shortened survival. However, the molecular and cellular mechanisms underpinning brain colonization by breast carcinoma cells are poorly understood. Here, we used 2D-DIGE (Difference in Gel Electrophoresis proteomic analysis followed by LC-tandem mass spectrometry to identify the proteins differentially expressed in brain-targeting breast carcinoma cells (MB231-Br compared with parental MDA-MB-231 cell line. Between the two cell lines, we identified 12 proteins consistently exhibiting greater than 2-fold (p<0.05 difference in expression, which were associated by the Ingenuity Pathway Analysis (IPA with two major signaling networks involving TNFα/TGFβ-, NFκB-, HSP-70-, TP53-, and IFNγ-associated pathways. Remarkably, highly related networks were revealed by the IPA analysis of a list of 19 brain-metastasis-associated proteins identified recently by the group of Dr. A. Sierra using MDA-MB-435-based experimental system (Martin et al., J Proteome Res 2008 7:908-20, or a 17-gene classifier associated with breast cancer brain relapse reported by the group of Dr. J. Massague based on a microarray analysis of clinically annotated breast tumors from 368 patients (Bos et al., Nature 2009 459: 1005-9. These findings, showing that different experimental systems and approaches (2D-DIGE proteomics used on brain targeting cell lines or gene expression analysis of patient samples with documented brain relapse yield highly related signaling networks, suggest strongly that these signaling networks could be essential for a successful colonization of the brain by metastatic breast carcinoma cells.

  20. Repeat stereotactic radiosurgery in the management of brain metastases from NSCLC: A case report and review of the literature

    OpenAIRE

    Marvaso, Giulia; BARONE, AGNESE; VACCARO, CATERINA; Bruzzaniti, Vicente; GRESPI, SILVIA; SCOTTI, VALERIO; Bianco, Cataldo

    2013-01-01

    The aims of radiotherapeutic treatment of brain metastases include maintaining neurocognitive function and improvement of survival. Based on these premises, we present a case report in which the role of repeat stereotactic radiosurgery (SRS) was investigated in a patient with a recurrent brain metastasis from non-small cell lung cancer in the same area as previously treated with radiosurgery. A 40-year-old male caucasian patient was diagnosed with brain metastasis from non-small cell lung can...

  1. Spinal Leptomeningeal Metastasis from Gastric Cancer: Case Report

    OpenAIRE

    Çokmert, Suna; Doğanay, Latife; Paköz, Burak; Yüksel, Alper; Gezer, Emrah; Alakavuklar, Mehmet Niyazi

    2015-01-01

    Leptomeninges are a rare region for metastasis in solid tumors. The most common causes of leptomeningeal metastasis are breast cancer, lung cancer, melanoma and leukemia-lymphomas. Leptomeningeal metastasis associated with gastric cancer is an exceedingly rare condition but it is rapidly progressive and poor prognosis. The diagnosis is confirmed by examination of the cerebrospinal fluid and imaging methods. There are several treatment options for patients with LMC, including intrathecal chemo...

  2. Medical and health economic assessment of radiosurgery for the treatment of brain metastasis

    Directory of Open Access Journals (Sweden)

    von der Schulenburg, Johann-Matthias

    2009-03-01

    Full Text Available Background: Radiotherapy for patients suffering from malignant neoplasms has developed greatly during the past decades. Stereotactic radiosurgery (SRS is one important radiotherapeutic option which is defined by a single and highly focussed application of radiation during a specified time interval. One of its important indications is the treatment of brain metastases. Objectives: The objective of this HTA is to summarise the current literature concerning the treatment of brain metastasis and to compare SRS as a single or additional treatment option to alternative treatment options with regard to their medical effectiveness/efficacy, safety and cost-effectiveness as well as their ethical, social and legal implications. Methods: A structured search and hand search of identified literature are performed from January 2002 through August 2007 to identify relevant publications published in English or German. Studies targeting patients with single or multiple brain metastases are included. The methodological quality of included studies is assessed according to quality criteria, based on the criteria of evidence based medicine. Results: Of 1,495 publications 15 medical studies meet the inclusion criteria. Overall study quality is limited and with the exception of two randomized controlleed trials (RCT and two meta-analyses only historical cohort studies are identified. Reported outcome measures are highly variable between studies. Studies with high methodological quality provide evidence, that whole-brain radiotherapy (WBRT in addition to SRS and SRS in addition to WBRT is associated with improved local tumour control rates and neurological function. However, only in patients with single brain metastasis, RPA-class 1 (RPA = Recursive partitioning analysis and certain primary tumour entities, this combination of SRS and WBRT is associated with superior survival compared to WBRT alone. Studies report no significant differences in adverse events between

  3. Brain irradiation for metastasis prevention and radiation treatment of small cell lung cancer metastases into the brain

    International Nuclear Information System (INIS)

    The report presents the results of cranial irradiation of 44 small cell lung cancer patients with clinically-identified intracranial metastases and 40 patients - for metastatic spread prevention. Whole brain irradiation was carried out with single doses of 2-4 Gy (total dose - 30-40 Gy) in both groups 5 times weekly. Patients irradiated for metastasis prevention revealed a 3.3 - fold decrease in intracranial metastasis frequency and a good post-treatment tolerance. In the other group, radiation failed to reach tumor lesions in 20%; treatment produced a poor effect in 30%. There was a correlation between survival time, initial expansion of process and tumor response to primary treatment. No relationship was observed between survival time and procedure and duration of cranial irradiation. Prophylactic irradiation may be beneficial in responders to therapy

  4. Isolated omental metastasis of renal cell carcinoma after extraperitoneal open partial nephrectomy: A case report

    Science.gov (United States)

    Acar, Ömer; Mut, Tuna; Sağlıcan, Yeşim; Sag, Alan Alper; Falay, Okan; Selcukbiricik, Fatih; Tabak, Levent; Esen, Tarık

    2016-01-01

    Introduction Metachronous metastatic spread of clinically localized renal cell carcinoma (RCC) affects almost 1/3 of the patients. They occur most frequently in lung, liver, bone and brain. Isolated omental metastasis of RCC has not been reported so far. Case presentation A 62-year-old patient previously diagnosed and treated due to pulmonary sarcoidosis has developed an omental metastatic lesion 13 years after having undergone open extraperitoneal partial nephrectomy for T1 clear-cell RCC. Constitutional symptoms and imaging findings that were attributed to the presence of a sarcomatoid paraneoplastic syndrome triggered by the development this metastatic focus complicated the diagnostic work-up. Biopsy of the [18F]-fluorodeoxyglucose (+) lesions confirmed the diagnosis of metastatic RCC and the patient was managed by the resection of the omental mass via near-total omentectomy followed by targeted therapy with a tyrosine kinase inhibitor. Discussion Late recurrence of RCC has been reported to occur in 10–20% of the patients within 20 years. Therefore lifelong follow up of RCC has been advocated by some authors. Diffuse peritoneal metastases have been reported in certain RCC subtypes with adverse histopathological features. However, isolated omental metastasis without any sign of peritoneal involvement is an extremely rare condition. Conclusion To our knowledge, this is the first reported case of metachronously developed, isolated omental metastasis of an initially T1 clear-cell RCC. Constitutional symptoms, despite a long interval since nephrectomy, should raise the possibility of a paraneoplastic syndrome being associated with metastatic RCC. Morphological and molecular imaging studies together with histopathological documentation will be diagnostic. PMID:26874583

  5. Surgical resection of adrenal metastasis from primary liver tumors:a report of two cases

    Institute of Scientific and Technical Information of China (English)

    Durgatosh Pandey; Kai-Chah Tan

    2008-01-01

    BACKGROUND: Although the treatment of extrahepatic metastases from primary liver tumors is essentially palliative, solitary metastasis from such tumors offers a possibility of cure by surgical resection. The adrenal gland is an uncommon site for metastasis from primary liver tumors. METHOD: We report two cases of adrenalectomy for solitary adrenal metastasis: one from intrahepatic cholangiocarcinoma and the other from hepatocellular carcinoma. RESULTS: The patient with intrahepatic cholangiocar-cinoma had a synchronous adrenal metastasis and underwent simultaneous liver resection and adrenalectomy. However, he developed recurrent disease 17 months following surgery for which he is presently on palliative chemotherapy. The other patient underwent adrenalectomy for adrenal metastasis 3 months following liver transplantation for hepatocellular carcinoma. He is presently alive and disease-free 27 months after adrenalectomy. CONCLUSION: Carefully selected patients with solitary metastasis from primary liver tumors may be considered for resection.

  6. Management of brain metastasis with magnetic resonance imaging and stereotactic irradiation attenuated benefits of prophylactic cranial irradiation in patients with limited-stage small cell lung cancer

    OpenAIRE

    Ozawa, Yuichi; Omae, Minako; Fujii, Masato; Matsui, Takashi; KATO, Masato; Sagisaka, Shinya; Asada, Kazuhiro; Karayama, Masato; Shirai, Toshihiro; Yasuda, Kazumasa; Nakamura, Yutaro; Inui, Naoki; Yamada, Kazunari; Yokomura, Koshi; Suda, Takafumi

    2015-01-01

    Background Magnetic resonance imaging (MRI) enables a more sensitive detection of brain metastasis and stereotactic irradiation (SRI) efficiently controls brain metastasis. In limited-stage small cell lung cancer (LS-SCLC), prophylactic cranial irradiation (PCI) in patients with good responses to initial treatment is recommended based on the survival benefit shown in previous clinical trials. However, none of these trials evaluated PCI effects using the management of brain metastasis with MRI...

  7. Skeletal Muscle Metastasis from a Cecal Mucinous Adenocarcinoma: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Dong Hyun; Lee, Young Hwan; Jung, Kyung Jae [Catholic University, Daegu (Korea, Republic of); Park, Young Chan; Kim, Ho Kyun; Cho, Seung Hyun [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2008-11-15

    Skeletal muscle metastasis is a relatively rare finding in the setting of mucinous adenocarcinoma of the colon, and it typically exhibits nonspecific imaging findings. We report a case of a skeletal muscle metastasis originating from mucinous adenocarcinoma of the cecum. The skeletal lesion closely resembled intramuscular myxoma with regard to imaging findings, due to abundant mucin and internal calcification.

  8. Dural metastasis from prostatic adenocarcinoma mimicking meningioma: Report of a case with unilateral loss of vision

    International Nuclear Information System (INIS)

    We report a case of PCa (prostatic adenocarcinoma) with transdural metastasis which radiologically simulated a meningioma. During the course of the disease, the patient complained of progressive unilateral loss of vision as the first presentation of intracranial, extra-axial metastasis

  9. Intramedullary metastasis in a case of vermian medulloblastoma.

    Science.gov (United States)

    Madhugiri, Venkatesh S; Pandey, Paritosh; Indira Devi, B; Santosh, Vani; Yasha, T C

    2012-04-01

    Medulloblastoma is one of the commonest primary CNS malignancies in children. Leptomeningeal dissemination and distant metastasis have been associated with medulloblastoma, but intramedullary metastases are very rare. CSF cytology and contrast-enhanced MRI are the main modalities used to diagnose leptomeningeal dissemination. However, intramedullary metastases are best picked up with contrast-enhanced axial sequences on MR imaging. In this report, a patient with medulloblastoma who developed intramedullary metastasis is described. The role of imaging and CSF cytology in diagnosing the spread along the CSF pathways is reviewed. Allusions are made to the possible mechanism of intramedullary metastasis in these tumors. PMID:21970778

  10. Palliative Surgery for Rare Cases of Anterior Urethral Metastasis in Prostate Cancer

    Science.gov (United States)

    Gómez Gómez, Enrique; Carrasco Aznar, Jose Carlos; Moreno Rodríguez, Maria del Mar; Valero Rosa, José; Requena Tapia, Maria José

    2014-01-01

    Penis metastasis from prostate cancer is very rare, and its management varies from case to case as there are very few cases reported in the literature. We describe a patient with prostate cancer treated with radiotherapy and androgen deprivation therapy who presented with urethral bleeding as a symptom of anterior urethral metastasis during followup. We propose a way to manage this and review the literature. PMID:25161796

  11. Palliative Surgery for Rare Cases of Anterior Urethral Metastasis in Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Enrique Gómez Gómez

    2014-01-01

    Full Text Available Penis metastasis from prostate cancer is very rare, and its management varies from case to case as there are very few cases reported in the literature. We describe a patient with prostate cancer treated with radiotherapy and androgen deprivation therapy who presented with urethral bleeding as a symptom of anterior urethral metastasis during followup. We propose a way to manage this and review the literature.

  12. Tongue metastasis as an initial presentation of renal cell carcinoma: a case report and literature review

    OpenAIRE

    Azam Faisal; Abubakerr Muneer; Gollins Simon

    2008-01-01

    Abstract Introduction Primary tumour of the kidney metastasizing to the tongue is very unusual and only anecdotal cases have been reported. An exhaustive literature review covering the period from 1911 onwards disclosed 28 cases. Out of those, only 3 cases presented initially with tongue metastases before the diagnosis of primary renal cell carcinoma. The prognosis for patients with lingual metastasis of renal cell carcinoma is poor. Treatment of tongue metastasis is usually palliative and ai...

  13. Urethral metastasis from non-seminomatous germ cell tumor: a case report

    OpenAIRE

    Joffe Johnathan; Chilka Sameer; Wah Tze; Agarwal Vijay; Stark Dan

    2011-01-01

    Abstract Introduction We present a case of nonseminomatous germ cell tumor of the testes with acute urinary retention secondary to urethral metastasis. This presentation, and similar cases of urethral metastasis from this tumor, have not been reported previously. Case presentation A 35-year-old Caucasian man presented to hospital with a history of acute urinary retention. On examination he was found to have right testicular enlargement with raised β-human chorionic gonadotrophin, serum α-feto...

  14. Pulmonary Neuroendocrine Tumor with Thyroid Gland Metastasis: Case Report

    Directory of Open Access Journals (Sweden)

    Cristina Corina Pop Radu

    2015-04-01

    Full Text Available Neuroendocrine tumors (NET represent approximately 20% of all primary neoplasms of the lung. Histologic confirmation is important for treatment and prognosis determination. NET are classified according to four subtypes in the lung: typical carcinoid tumor (TC, atypical carcinoid tumor (AC, small cell carcinoma (SCC, and large cell neuroendocrine carcinoma (LCNEC. TC is low-grade, AC is intermediate-grade, and SCC and LCNEC are high-grade malignancies. Case report: A 57 years old woman, affected by a cervical anterior tumor and a proliferative tissue below the glottis was referred to our Endocrinology Department from ENT service for a second opinion. An ultrasound scan of the neck showed a polynodular goiter with bilaterally lymph nodes enlargement with suspicious malignancy characters. She had undergone surgery for the cervical anterior mass and for the laryngeal biopsy. Histopathological examination results were consistent with a SCC; neoplastic cells showed immunoreactivity to synaptophysin, neuron specific enolase and chromogranin. The serum levels of serotonin, cromogranin A, calcitonin, carcinoembryonic antigen, ACTH, PTH, TSH, FT4 were normal. Fine needle aspiration biopsy of her left thyroid lobe nodule was performed and the cytopathological exam was compatible with a neuroendocrine tumor metastasis. Thoracic and abdominal computed tomography was normal at that moment. Chest CT revealed the primary pulmonary tumor at 6 months after presentation. The therapeutic option for advanced or metastatic NETs is mainly palliation of symptoms; options need to be individualized and, therefore, rely on the knowledge of multidisciplinary teams.

  15. Pelvis metastasis from primary choroidal melanoma: a case report

    Directory of Open Access Journals (Sweden)

    Xiong Y

    2014-11-01

    Full Text Available Yan Xiong, Yun Lang, Chongqi Tu, Hong Duan Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, People's Republic of China Abstract: The patient, a 16-year-old girl, was admitted to our hospital with complaints of right hip pain and claudication. Her past medical history indicated that 2 years earlier she had undergone enucleation of her left eye for a primary choroidal melanoma. Imaging studies revealed a osteolytic destruction with soft tissue mass involving the right hemipelvis (zone I–II. Single-photon emission computed tomography (SPECT and positron emission tomography–computed tomography (PET–CT showed no other sites of metastases. Consequently, the patient underwent hemipelvic prosthesis reconstruction after tumor resection. Postoperative pathological diagnosis was metastatic malignant melanoma. Thirty months after treatment, imaging studies indicated no evidence of recurrence, and functional recovery was excellent. To our knowledge, the literature does not reveal any previously reported cases of ocular choroidal melanoma that metastasized to pelvis, meanwhile was carried out hemipelvic prosthesis reconstruction after pelvic tumor resection. Keywords: melanoma, metastasis, pelvis, tumor, reconstruction

  16. Ovarian metastasis in colorectal cancer: retrospective review of 180 cases

    Directory of Open Access Journals (Sweden)

    Omranipour R

    2009-12-01

    ovarian metastasis in CRC was 2.7%, and isolated ovarian metastases occurred in less than half of them. Of 120 women that underwent colectomy alone, eight (6.6% developed ovarian metastasis during two years of follow-up. Only three cased had isolated ovarian metastases. No patient with synchronous or metachronous ovarian metastases from CRC survived five years."n"nConclusion: Isolated ovarian metastases from primary CRC occur with a low frequency and this may partially explain the debate regarding prophylactic oophorectomy at the time of curative resection for primary CRC.

  17. Intramedullary spinal cord metastasis from colonic carcinoma presenting as Brown-Sequard syndrome: a case report

    LENUS (Irish Health Repository)

    Kaballo, Mohammed A

    2011-08-02

    Abstract Introduction Intramedullary spinal cord metastasis is very rare. The majority are discovered incidentally during autopsy. Most symptomatic patients present with rapidly progressive neurological deficits and require immediate examination. Few patients demonstrate features of Brown-Séquard syndrome. Radiotherapy is the gold-standard of therapy for Intramedullary spinal cord metastasis. The overall prognosis is poor and the mortality rate is very high. We present what is, to the best of our knowledge, the first case of Intramedullary spinal cord metastasis of colorectal carcinoma presenting as Brown-Séquard syndrome. Case presentation We present the case of a 71-year-old Caucasian man with colonic adenocarcinoma who developed Intramedullary spinal cord metastasis and showed features of Brown-Séquard syndrome, which is an uncommon presentation of Intramedullary spinal cord metastasis. Conclusion This patient had an Intramedullary spinal cord metastasis, a rare form of metastatic disease, secondary to colonic carcinoma. The metastasis manifested clinically as Brown-Séquard syndrome, itself a very uncommon condition. This syndrome is rarely caused by intramedullary tumors. This unique case has particular interest in medicine, especially for the specialties of medical, surgical and radiation oncology. We hope that it will add more information to the literature about these entities.

  18. Identification and validation of S100A7 associated with lung squamous cell carcinoma metastasis to brain.

    Science.gov (United States)

    Zhang, Hao; Wang, Yinping; Chen, Yue; Sun, Suozhu; Li, Na; Lv, Dongxia; Liu, Chuanjun; Huang, Lingyun; He, Dacheng; Xiao, Xueyuan

    2007-07-01

    To identify potential markers associated with non-small cell lung cancer (NSCLC) metastasis to brain, comparative proteome analysis on two lung squamous cell carcinoma (SCC) cell lines, NCI-H226 and H226Br (the brain metastatic cell line of NCI-H226), was performed using two-dimensional electrophoresis (2-DE) followed by a tandem mass spectrometer with a matrix-assisted laser desorption/ionization (MALDI) source. Twenty differential proteins were identified, of which 6 proteins were up-regulated in H226Br cell compared with NCI-H226 cells, whereas 14 proteins were down-regulated. S100A7 and 14-3-3sigma, two of candidate proteins significantly upregulated and downregulated in H226Br cell, were selected to verify the liability of the differential proteins by Western blot. The results were in accordance with 2-D data. To determine whether S100A7 overexpression is actually associated with SCC metastasis to brain, S100A7 protein was testified in 10 brain metastasis tissues from NSCLC, 38 primary NSCLC tissues including half matched local positive lymph nodes, 5 primary brain tumors and 2 non-cancer brain tissues by immunohistochemistry. Of particular interest to us was that the positive staining of S100A7 could be found in 3/5 (60%) brain metastases tissue from SCC and 8/21 (38%) the primary lung SCC tissues, while no positive staining was observed in the brain metastases tissue from Ad (n=5), the primary adenocarcinoma (Ad) tissues (n=17), the primary brain tumors (n=5), all local positive lymph nodes from the primary NSCLC (n=19) and non-cancer brain tissues (n=2). These findings suggest that S100A7 expression is closely associated with SCC metastasis to brain and may be a potential biomarker for monitoring the development of SCC. PMID:17418446

  19. Metastasis to the penis. Case reports and review of the literature

    DEFF Research Database (Denmark)

    Osther, P J; Løntoft, E

    1991-01-01

    Metastasis to the penis is rare, despite rich vascularization and complex circulation. Less than 200 cases have been reported. Three new cases of penis metastasis from primary tumours in the bladder and prostate, respectively, are described. The most common symptoms are penile induration and...... swelling. Treatments, all of which must be considered merely palliative, consist of local tumour excision, radiation therapy, cytostatic and hormone therapy, possibly with partial or total penis amputation. The prognosis is poor, irrespective of the therapy and site of the primary tumour. More than 80% of...... the patients die within six months after the occurrence of penis metastasis, as a result of disseminated cancer disease....

  20. Unexpected metastasis of intraductal papillary mucinous neoplasm of the bile duct into thoracic cavity with direct extension: Case report

    International Nuclear Information System (INIS)

    Intraductal papillary mucinous neoplasm (IPMN) is known to arise from intraductal proliferation of mucinous cells with findings of marked dilatation of the biliary or pancreatic duct. There are reports of the metastasis and extension of pancreatic IPMN. However, cases of biliary IPMN with direct metastasis, or metastasis to distant locations, are rare. We present a case of metastasis of biliary IPMN with unexpected direct extension into the thoracic cavity, and we attempt to account for the mechanism of this extension

  1. Renal cell carcinoma metastasis to thyroid tumor: a case report and review of the literature

    OpenAIRE

    Medas, Fabio; Calò, Pietro Giorgio; Lai, Maria Letizia; Tuveri, Massimiliano; Pisano, Giuseppe; Nicolosi, Angelo

    2013-01-01

    Introduction Metastatic neoplasms to the thyroid gland are rare in clinical practice. Clear cell renal carcinoma is the most frequent site of origin of thyroid metastases and represents 12 to 34% of all secondary thyroid tumors. Tumor-to-tumor metastases, in which a thyroid neoplasm is the recipient of a metastasis, are exceedingly rare. We report a case of clear cell renal carcinoma metastatic to a follicular adenoma. This is the tenth case of renal cell carcinoma metastasis to thyroid tumor...

  2. Diffuse Interstitial Infiltrative Lung Metastasis of Malignant Melanoma: a Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Na young; Hong, Yoo Jin; Kim, Ah Hyun; Shim, Hyo Sub; Nam, Ji Eun; Lee, Hye Jeong; Kim, Myung Joon [Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2011-04-15

    A diffuse interstitial infiltrative pattern of lung metastasis in a patient with malignant melanoma is rare and can be confused with benign conditions such as pulmonary edema or drug-induced pneumonitis. We experienced a case of diffuse interstitial infiltrative lung metastasis in malignant melanoma in a 37-year-old man. This case was confirmed by a transbronchial lung biopsy. We herein describe the findings on CT and positron emission tomography scan

  3. Subcutaneous metastasis in medulloblastoma: A case report and review of literature

    OpenAIRE

    Tanmoy Maiti; Paramveer Sabharwal; Paritosh Pandey; B Indira Devi

    2013-01-01

    Extraneural metastasis (ENM) in patients with medulloblastoma is a rare but a well-described phenomenon, both in children and adults. Most of the ENM involve bone and bone marrow and rarely involve other solid organs. Subcutaneous and muscular metastasis is an extremely rare event, more so in children, with only two cases documented in the pediatric population. We describe a case of medulloblastoma with ENM in right masseter and subcutaneous plane along with concomitant central nervous system...

  4. Surgery Versus Stereotactic Radiosurgery for Single Synchronous Brain Metastasis from Non-Small Cell Lung Cancer

    Institute of Scientific and Technical Information of China (English)

    Hui LI; Sheng-cai HOU; Bin HU; Tong LI; Yang Wang; Jin-bai Miao; Bin You; Yi-li Fu

    2009-01-01

    Objective: The aim of this study is to compare the effectiveness of surgery with stereotactic radiosurgery (SRS) for patients with a single synchronous brain metastasis from successfully treated non-small cell lung cancer.Methods: Between 1995 and 2002, 53 patients underwent resection of both primary non-small cell lung cancer and the associated single brain metastasis. There were 33 men and 20 women with a mean age of 57 years (range, 32(85 years). At the time of diagnosis, 42 patients experienced lung cancer related symptoms, whereas 11 patients experienced brain metastases-related symptoms. 42 patients had received thoracic surgery first, and 11 patients had undergone neurosurgery or radiosurgery first. Pneumonectomy was performed in 9 out of 42 patients (21.4%), lobectomies in 30 (71.4%), and wedge resection in 3 (7.2%). 48 patients (90.5%) underwent complete lymphadenectomy. 35 patients underwent brain metastasectomy. 18 underwent SRS.Results: There was no postoperative mortality and severe complications after either lung or brain surgery. Histology showed 34 adenocarcinomas, 16 squamous cell carcinomas, and 3 large cell lung cancers. 15 patients (28.3%) had no evidence of lymph node metastases (N0), 20 patients (37.7%) had hilar metastases (N1), and 18 patients (34%) had mediastinal metastases (N2). The 1-, 2-, 3- and 5-year overall survival rates were 49%, 19%, 10%, and 5%, respectively. The corresponding data for neurosurgery group were 55%, 17%, 11%, and 6%, respectively. The median survival time was 13 months. For SRS group the corresponding data were 44.8%, 20.9% 10.5%, and 2%, respectively. The median survival time was 14 months. The differences between the two groups were not significant (P>0.05). In lymph node negative patients (N0), the overall 5-year survival rate was 10%, as compared with a 1% survival rate in patients with lymph node metastases (N1(2). The difference was significant (P0.05).Conclusion: Although the overall survival rate for

  5. Growing Teratoma Syndrome of the Ovary Showing Three Patterns of Metastasis: A Case Report

    Directory of Open Access Journals (Sweden)

    Kiyosumi Shibata

    2013-11-01

    Full Text Available Growing teratoma syndrome (GTS is defined as metastatic masses during or after chemotherapy for germ cell tumors, which contain only mature teratoma components. The peritoneum of the pelvis and abdomen and the retroperitoneum are the most frequent sites of metastasis. We report a case of GTS of the ovary showing three patterns of metastasis: dissemination, lymphogenous metastasis, and hematogenous metastasis. The patient initially presented 5 years ago with a mixed germ cell tumor of the left ovary and positive cytology of ascites. After surgery and chemotherapy, mature teratomas recurred as pelvic peritoneal dissemination, a para-aortic lymph node mass, and a lung mass. Our case highlights the importance of long-term follow-up and a whole-body search. We think that our case is suggestive regarding the mechanism of critical GTS.

  6. Small bowel perforation due to indistinguishable metastasis of angiosarcoma: case report and brief literature review.

    Science.gov (United States)

    Uchihara, Tomoyuki; Imamura, Yu; Iwagami, Shiro; Kajihara, Ikko; Kanemaru, Hisashi; Karashima, Ryuichi; Ida, Satoshi; Ishimoto, Takatsugu; Baba, Yoshifumi; Sakamoto, Yasuo; Miyamoto, Yuji; Yoshida, Naoya; Watanabe, Masayuki; Iyama, Ken-Ichi; Ihn, Hironobu; Baba, Hideo

    2016-12-01

    Intestinal metastasis of angiosarcoma is extremely rare. We herein report a case of intestinal perforation due to intestinal metastasis of angiosarcoma. The patient was a 72-year-old Japanese man with multiple recurrent angiosarcomas of the scalp. He developed acute abdominal pain with guarding, and we performed an emergency exploratory laparotomy. An intestinal perforation was found 80 cm from the ligament of Treitz, and partial jejunectomy was successfully performed. Macroscopic inspection revealed no obvious injury, ulcer, or tumor at or around the perforation site. Pathological examination revealed angiosarcoma cells penetrating through all layers of the jejunum at the site of intestinal perforation. This is the first reported case of intestinal perforation caused by indistinguishable intestinal metastasis of angiosarcoma. This case emphasizes intestinal metastasis of angiosarcoma as a possible cause of small bowel perforation in patients with advanced angiosarcoma, even when no visible tumor is present during surgery. PMID:27156097

  7. Evaluation of Different Score Index for Predicting Prognosis in Gamma Knife Radiosurgical Treatment for Brain Metastasis

    International Nuclear Information System (INIS)

    Purpose: To assess the utility of the Radiation Therapy Oncology Group Recursive Partitioning Analysis (RPA) and Score Index for Radiosurgery (SIR) stratification systems in predicting survival in patients with brain metastasis treated with Gamma Knife radiosurgery (GKRS). Methods and Materials: A total of 185 patients were included in the study. Patients were stratified according to RPA and SIR classes. The RPA and SIR classes, age, Karnofsky Performance Status (KPS), and systemic disease were correlated with survival. Results: Five patients were lost to follow-up. Median survival in patients in RPA Class 1 (30 patients) was 17 months; in Class 2 (140 patients), 10 months; and in Class 3 (10 patients), 3 months. Median survival in patients in SIR Class 1 (30 patients) was 3 months; in Class 2 (135 patients), 8 months; and in Class 3 (15 patients), 20 months. In univariate testing, age younger than 65 years (p = 0.0004), KPS higher than 70 (p = 0.0001), RPA class (p = 0.0078), SIR class (p = 0.0002), and control of the primary tumor (p = 0.02) were significantly associated with improved outcome. In multivariate analysis, KPS (p < 0.0001), SIR class (p = 0.0008), and RPA class (p = 0.03) had statistical value. Conclusions: This study supports the use of GKRS as a single-treatment modality in this selected group of patients. Stratification systems are useful in the estimation of patient eligibility for GKRS. A second-line treatment was necessary in 30% of patients to achieve distal or local brain control. This strategy is useful to control brain metastasis in long-surviving patients.

  8. Survival Analysis of Patients with Brain Metastasis by Weighting According to the Primary Tumor Oncotype

    Energy Technology Data Exchange (ETDEWEB)

    Gwak, Hee Keun; Kim, Woo Chul; Kim, Hun Jung; Park, Jung Hoon; Song, Chang Hoon [Inha University Hospital, Incheon (Korea, Republic of)

    2009-09-15

    This study was performed to retrospectively analyze patient survival by weighting according to the primary tumor oncotype in 160 patients with brain metastasis and who underwent whole brain radiotherapy. A total of 160 metastatic brain cancer patients who were treated with whole brain radiotherapy of 30 Gy between 2002 and 2008 were retrospectively analyzed. The primary tumor oncotype of 20 patients was breast cancer, and that of 103 patients was lung cancer. Except for 18 patients with leptomeningeal seeding, a total of 142 patients were analyzed according to the prognostic factors and the Recursive Partitioning Analysis (RPA) class. Weighted Partitioning Analysis (WPA), with the weighting being done according to the primary tumor oncotype, was performed and the results were correlated with survival and then compared with the RPA Class. The median survival of the patients in RPA Class I (8 patients) was 20.0 months, that for Class II (76 patients) was 10.0 months and that for Class III (58 patients) was 3.0 months (p<0.003). The median survival of patients in WPA Class I (3 patients) was 36 months, that for the patients in Class II (9 patients) was 23.7 months, that for the patients in Class III (70 patients) was 10.9 months and that for the patients in Class IV (60 patients) was 8.6 months (p<0.001). The WPA Class might have more accuracy in assessing survival, and it may be superior to the RPA Class for assessing survival. A new prognostic index, the WPA Class, has more prognostic value than the RPA Class for the treatment of patients with metastatic brain cancer. This WPA Class may be useful to guide the appropriate treatment of metastatic brain lesions.

  9. Occult Invasive Lobular Carcinoma of Breast Detected by Stomach Metastasis: A Case Report

    International Nuclear Information System (INIS)

    Gastric metastasis from primary breast cancer is a rare phenomenon that is more prevalent in the invasive lobular type of breast cancer. We describe a very rare case of occult invasive lobular cancer of the breast detected by the initial presentation of gastric metastasis in a patient without a history of breast cancer. A 18F-fluorodeoxyglucose positron-emission tomography/computed tomography (FDG PET/CT) which showed increased FDG uptake in the stomach, abdominal mesentery and the right breast, and played pivotal roles in the detection of occult primary breast cancer and a diagnosis of gastric metastasis as an ancillary method for obtaining histological results and immunohistochemical stains.

  10. Occult Invasive Lobular Carcinoma of Breast Detected by Stomach Metastasis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    KIm, So Jung; Jung, Hae Kyoung; Ko, Kyung Hee; Yoon, Jung Hyun [Dept. of Radiology, Bundang CHA general Hospital, CHA University College of Medicine, Seongnam (Korea, Republic of)

    2012-02-15

    Gastric metastasis from primary breast cancer is a rare phenomenon that is more prevalent in the invasive lobular type of breast cancer. We describe a very rare case of occult invasive lobular cancer of the breast detected by the initial presentation of gastric metastasis in a patient without a history of breast cancer. A 18F-fluorodeoxyglucose positron-emission tomography/computed tomography (FDG PET/CT) which showed increased FDG uptake in the stomach, abdominal mesentery and the right breast, and played pivotal roles in the detection of occult primary breast cancer and a diagnosis of gastric metastasis as an ancillary method for obtaining histological results and immunohistochemical stains.

  11. Pulmonary sclerosing hemangioma with lymph node metastasis: A case report and literature review.

    Science.gov (United States)

    Adachi, Yasushi; Tsuta, Koji; Hirano, Ryuji; Tanaka, Jin; Minamino, Keizo; Shimo, Tomohiko; Ikehara, Susumu

    2014-04-01

    Pulmonary sclerosing hemangioma (SH) is an uncommon benign or low-grade malignant tumor. Multicentric SH and SH with lymph node metastasis have rarely been reported. The present report describes a case of pulmonary SH with lymph node metastasis in a middle-aged female. A nodule was found incidentally in the lower left lung. The patient underwent left lower pulmonary lobectomy and lymph node dissection. Histologically, the nodule demonstrated the characteristic features of SH and one of the resected lymph nodes contained a metastasis of this tumor. Thus, pulmonary SH has the potential to metastasize, a potential not suggested by histological features. PMID:24944657

  12. A rare case of isolated adrenal metastasis of invasive ductal breast carcinoma

    Directory of Open Access Journals (Sweden)

    Anđelić-Dekić Nataša

    2014-01-01

    Full Text Available Introduction. Isolated adrenal metastases of invasive ductal breast carcinoma are extremely rare. We report a case with isolated left adrenal metastases, verified three years after diagnosed breast carcinoma. Case Outline. A 58-year-old female patient with a right breast tumor, clinically staged as IIIA (T2N2M0 started neoadjuvant anthracycline chemotherapy after biopsy which revealed invasive ductal breast carcinoma. Immunohistochemical findings of tumor biopsy showed hormonal steroid receptors for estrogen and progesterone negative, and human epidermal growth factor receptor 2 (HER2 positive. After 4 cycles of chemotherapy and partial tumor regression the patient underwent radical mastectomy. Definite histopathological analysis confirmed the diagnosis of invasive ductal carcinoma. The patient continued treatment with adjuvant chemotherapy to cumulative dose of anthracyclines, postoperative radiotherapy and adjuvant trastuzumab for one year. Three years later abdominal computerized tomography showed tumor in the left adrenal gland as the only metastatic site. Left adrenalectomy was performed and histopathological finding confirmed breast cancer metastases. Postoperatively, the patient received 6 cycles of docetaxel with trastuzumab and continued trastuzumab until disease progression. One year after left adrenalectomy control abdominal computerized tomography showed a right adrenal tumor with retroperitoneal lymphadenopathy. Treatment with capecitabine was continued for one year, but eventually she developed brain metastasis causing lethal outcome. Conclusion. In order to better understand metastatic pathways of invasive ductal breast carcinoma, publications of individual patient cases diagnosed with rare metastatic sites should be encouraged. This might improve our understanding of metastatic behavior of breast cancer and stimulate further clinical research.

  13. Survival following gamma knife radiosurgery for brain metastasis from breast cancer

    International Nuclear Information System (INIS)

    Breast cancer is the second most common cause of brain metastases in the United States. Although breast cancer induced brain metastases represent an incurable condition, some patients experience prolonged survival. In this retrospective study, we examine a cohort of patients with brain metastases from breast cancer treated with Gamma Knife stereotactic radiosurgery to identify factors that predict better outcomes. A retrospective database of 100 patients treated for brain metastases due to breast cancer via Gamma Knife radiosurgery (GKS) from July 1998 through March 2009 was reviewed. Patients who received radiosurgery as sole treatment, as a planned boost after whole brain radiotherapy or surgical resection, or as salvage after prior whole brain radiation therapy (WBRT) or surgical resection were included. Prognostic factors identified to be significant for survival in previous brain metastasis studies were analyzed for significance by univariate and multivariate Cox analysis. Overall, the median brain progression-free survival time was 7.1 months and the median survival time was 12.3 months. No prognostic variables were significant for brain progression-free survival. For patients treated with a planned GKS after WBRT, GKS as sole treatment, GKS salvage after WBRT, GKS boost after surgery, or GKS for surgical salvage the median survival times (MSTs) were as follows: 12.2 months, 12.4 months, 9.5 months, 27.6 months and 33.4 months respectively. Differences between the groups were not significant (p = 0.06); however, GKS boost after surgery and GKS for salvage after surgery did have a trend toward better overall survival. The MST for patients of age <65 years was 14.5 months, compared to age ≥65 which was 7.7 months (p = 0.06) and remained a significant prognostic factor for overall survival on multivariate analysis. The MST for patients with a single lesion was 16.9 months, not significantly different than the MST of 14.5 months for patients with 2–3 lesions

  14. Automated tracking of nanoparticle-labeled melanoma cells improves the predictive power of a brain metastasis model

    Czech Academy of Sciences Publication Activity Database

    Sundstrom, T.; Daphu, I.; Wendelbo, I.; Hodneland, E.; Lundervold, A.; Immervoll, H.; Skaftnesmo, K. O.; Babič, Michal; Jendelová, Pavla; Syková, Eva; Lund-Johansen, M.; Bjerkvig, R.; Thorsen, F.

    2013-01-01

    Roč. 73, č. 8 (2013), s. 2445-2456. ISSN 0008-5472 R&D Projects: GA ČR(CZ) GAP304/12/1370 Institutional support: RVO:61389013 ; RVO:68378041 Keywords : brain metastasis * MRI * nanoparticles Subject RIV: CD - Macromolecular Chemistry; FD - Oncology ; Hematology (UEM-P) Impact factor: 9.284, year: 2013

  15. Metastasis of Lung Adenocarcinoma to the Gingiva: A Rare Case Report

    OpenAIRE

    Rajini Kanth, M.; A Ravi Prakash; Y. Raghavendra Reddy; Sonia Bai; M. Ravindra Babu

    2015-01-01

    Metastatic tumors account for 1% of all oral malignancies. Metastasis to jaw bones is common, particularly in the mandible, rare in the oral soft tissues, and account for only 0.1% of oral malignancies. The majority of metastatic cases (70%) reported in the literature have primary tumors located in the lung, breast, kidney, and colon. Metastasis is a biological complex process that involves detachment from the surrounding cells, regulation of cell motility, invasion, survival, proliferation, ...

  16. 'Prechronous' metastasis in clear cell renal cell carcinoma: a case report

    OpenAIRE

    Chong Tsung; Mohd Zam Nor; Lim Wan; Chuang Xue; Ong Sin; Poon Eileen; Al Jajeh Issam; Mancer Kent; Tan Min-Han

    2011-01-01

    Abstract Introduction Although metastatic carcinoma in the presence of an occult primary tumor is well recognized, underlying reasons for the failure of the primary tumor to manifest are uncertain. Explanations for this phenomenon have ranged from spontaneous regression of the primary tumor to early metastasis of the primary tumor before manifestation of a less aggressive primary tumor. We report a case of 'prechronous' metastasis arising from clear cell renal cell carcinoma, where metastatic...

  17. Cutaneous metastasis of gastric cardia adenocarcinoma in a patient: a case report

    OpenAIRE

    Ying WANG; Kong, Guoqiang; Yuan, Xiaozhi; Gao, Shegan

    2014-01-01

    A large proportion of gastric cardia adenocarcinoma (GCA) present initially in an advanced stage in China. Skin metastasis of primary GCA rarely occurs and the incidence of it is still unclear yet. Here we report one case of skin metastasis from GCA in a 58-year-old male patient who underwent gastric cardia resection in 2002 and did not undergo chemotherapy. However, he was diagnosed with anastomotic stoma adenocarcinoma by gastroscopy and histological biopsy in 2012.4. Then he underwent four...

  18. Pulmonary sclerosing hemangioma with lymph node metastasis: A case report and literature review

    OpenAIRE

    Adachi, Yasushi; Tsuta, Koji; HIRANO, RYUJI; TANAKA, JIN; Minamino, Keizo; Shimo, Tomohiko; Ikehara, Susumu

    2014-01-01

    Pulmonary sclerosing hemangioma (SH) is an uncommon benign or low-grade malignant tumor. Multicentric SH and SH with lymph node metastasis have rarely been reported. The present report describes a case of pulmonary SH with lymph node metastasis in a middle-aged female. A nodule was found incidentally in the lower left lung. The patient underwent left lower pulmonary lobectomy and lymph node dissection. Histologically, the nodule demonstrated the characteristic features of SH and one of the re...

  19. Radiotherapeutic palliation of brain metastasis: a retrospective quality of life analysis

    International Nuclear Information System (INIS)

    PURPOSE/OBJECTIVE: To assess quality of life effects of radiation therapy on patients with brain metastasis. Not only is data on this subject rare, there is also no psychometrically tested brain metastasis symptom scale. We report data using a scale of our own design. MATERIALS and METHODS: Over 200 charts of patients treated for brain metastasis from various primary sites between 1990 and 1995 were reviewed. Seventy-two patients met the criteria for evaluation. They were all treated with radiotherapy and steroids. The majority of patients received a median dose of 30 Gy (Range 20 - 55) to the whole brain. Treatment over 40 Gy was delivered via a boost, either external beam or stereotactic. Pre and post-therapy symptoms of impaired vision, speech, sensation, motor strength, gait, cranial nerves, headache, seizure, lethargy, mentation, and nausea and vomiting were scored. Each symptom was evaluated separately. Following therapy, patients were noted to have improvement, no change, or worsening symptoms. Steroid and anti-seizure medication use pre and post-therapy were also recorded. RESULTS: Patient characteristics: median age is 62 (Range 27 - 82 years); Female: Male 1.4:1; Single: Multiple metastasis = 1:2.3. The primary sites included: lung=56%, breast=15%, unknown=11%, and various=18%. The histologies included: adenocarcinoma=26%, squamous cell carcinoma=21%, small cell carcinoma=15%, infiltrating ductal=14%, and various=24%. All patients had a minimum of one month post-treatment follow up (Range 1 - 24 mths). Sixteen patients are still living. Eighty-nine percent were symptomatic at presentation and 36% presented with only one symptom. The incidence of symptoms before treatment was: altered mentation=26%, decreased motor strength=26%, headache=24%, seizure=21%, altered gait=20%, nausea/vomiting=18%, speech deficit=15%, lethargy=11%, visual change=8%, altered sensation=7%, and cranial nerve deficits=3%. A statistically significant improvement in mentation (p<0

  20. Peptic ulcer disease and other complications in patients receiving dexamethasone palliation for brain metastasis

    International Nuclear Information System (INIS)

    A retrospective analysis was done of 106 patients who received radiation therapy for brain metastasis. Dexamethasone therapy was instituted in 97 patients. Peptic ulcer disease developed in 5 of 89 patients (5.6 percent) who received a dosage of at least 12 mg a day, but did not occur in patients who received a lower dose or in those who did not receive steroids. The interval between institution of dexamethasone therapy and the development of peptic ulcer disease ranged from three to nine weeks. Two patients had perforated ulcers, one of whom required surgical resection. Peptic ulcer disease contributed to the general deterioration and death of three of the five patients. Overall, in 14 of the 89 patients (15.7 percent) a complication of steroid therapy developed in the form of peptic ulcer disease, steroid myopathy or diabetes mellitus (or a combination of these)

  1. Non small-cell lung cancer with metastasis to thigh muscle and mandible: two case reports

    OpenAIRE

    Giugliano, Francesca Maria; Alberti, Domingo; Guida, Giovanna; Palma, Giampaolo De; Iadanza, Luciano; Mormile, Maria; Cammarota, Fabrizio; Montanino, Agnese; Fulciniti, Franco; Ravo, Vincenzo; Muto, Paolo

    2013-01-01

    Introduction Lung cancer is the leading cause of cancer-related death in Europe and the US. Isolated metastases to skeletal muscle and the mandible are very uncommon. Case presentation This report presents two cases. Case 1 concerns a 45-year-old Caucasian woman affected by muscle metastasis of the right thigh from non-small-cell lung cancer. Case 2 concerns a 61-year-old Caucasian man affected by mandible metastasis from non-small-cell lung cancer. Both metastases were detected by diagnostic...

  2. Dosimetric comparison of Helical Tomotherapy and Gamma Knife Stereotactic Radiosurgery for single brain metastasis

    Directory of Open Access Journals (Sweden)

    Linskey Mark E

    2006-08-01

    Full Text Available Abstract Background Helical Tomotherapy (HT integrates linear accelerator and computerized tomography (CT technology to deliver IMRT. Targets are localized (i.e. outlined as gross tumor volume [GTV] and planning target volume [PTV] on the planning kVCT study while daily MVCT is used for correction of patient's set-up and assessment of inter-fraction anatomy changes. Based on dosimetric comparisons, this study aims to find dosimetric equivalency between single fraction HT and Gamma Knife® stereotactic radiosurgery (GKSRS for the treatment of single brain metastasis. Methods The targeting MRI data set from the GKSRS were used for tomotherapy planning. Five patients with single brain metastasis treated with GKSRS were re-planned in the HT planning station using the same prescribed doses. There was no expansion of the GTV to create the PTV. Sub-volumes were created within the PTV and prescribed to the maximum dose seen in the GKSRS plans to imitate the hot spot normally seen in GKSRS. The PTV objective was set as a region at risk in HT planning using the same prescribed dose to the PTV periphery as seen in the corresponding GKSRS plan. The tumor volumes ranged from 437–1840 mm3. Results Conformality indices are inconsistent between HT and GKSRS. HT generally shows larger lower isodose line volumes, has longer treatment time than GKSRS and can treat a much larger lesion than GKSRS. Both HT and GKSRS single fraction dose-volume toxicity may be prohibitive in treating single or multiple lesions depending on the number and the sizes of the lesions. Conclusion Based on the trend for larger lower dose volumes and more constricted higher dose volumes in HT as compared to GKSRS, dosimetric equivalency was not reached between HT and GKSRS.

  3. Dosimetric comparison of Helical Tomotherapy and Gamma Knife Stereotactic Radiosurgery for single brain metastasis

    International Nuclear Information System (INIS)

    Helical Tomotherapy (HT) integrates linear accelerator and computerized tomography (CT) technology to deliver IMRT. Targets are localized (i.e. outlined as gross tumor volume [GTV] and planning target volume [PTV]) on the planning kVCT study while daily MVCT is used for correction of patient's set-up and assessment of inter-fraction anatomy changes. Based on dosimetric comparisons, this study aims to find dosimetric equivalency between single fraction HT and Gamma Knife® stereotactic radiosurgery (GKSRS) for the treatment of single brain metastasis. The targeting MRI data set from the GKSRS were used for tomotherapy planning. Five patients with single brain metastasis treated with GKSRS were re-planned in the HT planning station using the same prescribed doses. There was no expansion of the GTV to create the PTV. Sub-volumes were created within the PTV and prescribed to the maximum dose seen in the GKSRS plans to imitate the hot spot normally seen in GKSRS. The PTV objective was set as a region at risk in HT planning using the same prescribed dose to the PTV periphery as seen in the corresponding GKSRS plan. The tumor volumes ranged from 437–1840 mm3. Conformality indices are inconsistent between HT and GKSRS. HT generally shows larger lower isodose line volumes, has longer treatment time than GKSRS and can treat a much larger lesion than GKSRS. Both HT and GKSRS single fraction dose-volume toxicity may be prohibitive in treating single or multiple lesions depending on the number and the sizes of the lesions. Based on the trend for larger lower dose volumes and more constricted higher dose volumes in HT as compared to GKSRS, dosimetric equivalency was not reached between HT and GKSRS

  4. Metastasis of Lung Adenocarcinoma to the Gingiva: A Rare Case Report

    Directory of Open Access Journals (Sweden)

    M. Rajini Kanth

    2015-05-01

    Full Text Available Metastatic tumors account for 1% of all oral malignancies. Metastasis to jaw bones is common, particularly in the mandible, rare in the oral soft tissues, and account for only 0.1% of oral malignancies. The majority of metastatic cases (70% reported in the literature have primary tumors located in the lung, breast, kidney, and colon. Metastasis is a biological complex process that involves detachment from the surrounding cells, regulation of cell motility, invasion, survival, proliferation, and evasion of the immune system. Clinical presentation of metastatic tumors is variable, which may create diagnostic dilemma or may lead to erroneous diagnosis. Metastatic tumors clinically mimic as dental infections. Metastasis to the oral soft tissue from lung cancer, especially gingiva is a rare condition. Metastasis to the gingiva can affect the oral function, speech, and nutrition. Most of the cases in the literature reported that lesion presented in oral soft tissues before the diagnosis of primary tumors. Here we report a case of 62-year-old male patient with metastasis from lung to the gingiva, where the metastasis was detected before primary tumor.

  5. Lingual metastasis from renal cell carcinoma: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Camillo Porta

    2012-06-01

    Full Text Available Renal cell carcinoma (RCC accounts for the 3% of all solid tumors. Despite continuous improvement in the therapy regimen, less has been achieved in terms of enabling an earlier diagnosis: the neoplasia usually reveals its presence at an advanced stage, obviously affecting prognosis. The most frequent sites of secondary disease are shown to be lungs (50-60%, bone (30-40%, liver (30-40% and brain (5%; while the head and neck district seems to account for less than 1% of patients with primary kidney lesion. We report here the case of a 70-year old man who presented with acute renal failure due to abdominal recurrence of RCC 18 years post nephrectomy. After a few months of follow up without any systemic therapy due to the renal impairment, the patient presented a vascularized tongue lesion that was demonstrated to be a secondary localization of the RCC. This lesion has, therefore, been treated with microsphere embolization to stop the frequent bleeding and to lessen the unbearable concomitant symptoms it caused, such as dysphagia and pain. A tongue lesion that appears in a RCC patient should always be considered suspect and a multidisciplinary study should be conducted both to assess whether it is a metastasis or a primary new lesion and to understand which method should be selected, if necessary, to treat it (surgery, radiation or embolization. Lingual metastasis should be examined accurately not only because they seem to implicate a poor prognosis, but also because they carry a burden of symptoms that not only threatens patients’ lives but also has a strong impact on their quality of life.

  6. Cerebral metastasis prom choriocarcinoma and oncotic aneurysms: case report

    Directory of Open Access Journals (Sweden)

    Pasquale Gallo

    1993-06-01

    Full Text Available Cerebral metastasis occur in 10 to 20% of patients with choriocarcinoma. We describe the twelfth patient with oncotic aneurysms from choriocarcinoma verified by cerebral angiography. The importance to consider this disease in a woman of childbearing age who develop an intracerebral hemorrhage or a lesion with mass effect is emphasized, as well as laboratorial and radiological characteristics. Therapeutic approaches with chemotherapic agents, surgery and irradiation are discussed.

  7. [Penile metastasis of prostatic carcinoma: a case report].

    Science.gov (United States)

    Musci, R; Del Boca, C; Ferrari, C; Grignani, G C

    1991-03-01

    Penile metastases are uncommon lesions: most often secondary to a primary pelvic cancer (prostate, bladder and rectum) they have a unfavourable prognosis. The appearance of disseminations is still controversial and there is not an efficacious therapy. Priapism may be present or not. The Authors report their experience on a penile metastasis secondary to prostatic cancer and about the evolution of this pathology. A review of the Literature is done. PMID:1830411

  8. Papillary thyroid carcinoma with massive metastasis in the uterine corpus: a case report

    International Nuclear Information System (INIS)

    Distant metastases stemming from a papillary thyroid carcinoma (PTC) are quite rare. Here we report an exceptional case of PTC presenting with cervical lymphatic and uterine metastases. This is the first case report of a PTC with uterine involvement. A 60-year-old Chinese woman came to our hospital complaining of discomfort in the throat that she had been experiencing for about half a month. PTC and cervical lymphatic metastasis were diagnosed after ultrasound examinations. A massive heterogeneous mass was found beside the uterus during the pre-operative checkup and a diagnosis of ovarian carcinoma was suspected after a thorough case discussion. However, it proved to be a metastasis from the PTC as determined by pathological and immunohistochemical examinations after the operation. The patient declined further treatments. She was followed for 22 months with no sign of recurrence detected. In this report, an unusual case of PTC was presented. The patient had not only regional lymphatic metastasis, but also had a massive metastasis in the uterine corpus, which was initially misdiagnosed as ovarian carcinoma. This case is of interest because of its rarity and exceptionally good prognosis. The reason for the misdiagnosis was attributed to overlooking the possibility of a distant metastasis coming from a PTC. This case raises the issue that completing an iodine-131 scan before operating on patients with PTC may be warranted

  9. Complex pattern of colon cancer recurrence including a kidney metastasis: A case report

    Institute of Scientific and Technical Information of China (English)

    Helfried Waleczek; Moritz N Wente; Jürgen Kozianka

    2005-01-01

    We report a case of a 77-year-old female with a local recurrence of cancer after right hemicolectomy which infiltrated the pancreatic head affording pancreatoduodenectomy, who developed 3 years later recurrent tumor masses localized in the mesentery of the jejunum and in the lower pole of the left kidney. Partial nephrectomy and a segment resection of the small bowel were performed. Histological examination of both specimens revealed a necrotic metastasis of the primary carcinoma of the colon. Although intraluminal implantation of colon cancer cells in the renal pelvic mucosa from ureteric metastasis has been described, metastasis of a colorectal cancer in the kidney parenchyma is extremely rare and can be treated in an organ preserving manner. A complex pattern of colon cancer recurrence with unusual and rare sites of metastasis is reported.

  10. Ultrasonography findings of thyroid metastasis in a patient with hepatocellular carcinoma: A case report

    International Nuclear Information System (INIS)

    Although the thyroid gland is one of the most vascular organs of the body, metastatic disease in the thyroid is encountered infrequently. However, at autopsy, the incidence rate of thyroid metastasis ranges from 1.25% to 24%. The primary sites are the kidney, lung, breast, and gastrointestinal tract. We report a rare case of a hepatocellular carcinoma metastatic to the thyroid gland. The patient had multiple palpable masses in the anterior and left lateral neck along the internal jugular chain on physical examination 9 months after the initial diagnosis of liver tumor. These masses were confirmed as metastasis from hepatocellular carcinoma by ultrasonography-guided 16-G core needle biopsy. We discuss the sonographic findings of thyroid metastasis and their use as an additional aid for differentiating between unknown primary tumor and thyroid metastasis.

  11. Apropos of a case of cutaneous metastasis from laryngeal cancer with review of literature

    Directory of Open Access Journals (Sweden)

    Romeeta Trehan

    2015-01-01

    Full Text Available Cutaneous metastasis from laryngeal carcinoma is a rare occurrence. A 55-year-old male patient with supraglottic cancer was treated with concurrent chemoradiation. Eighteen months later, he presented with ulceroproliferative growth on dorsum of the right hand. Biopsy revealed metastatic squamous cell carcinoma. Further investigations revealed underlying bone destruction with lung metastasis. In view of poor general condition and widespread dissemination of disease, palliative radiotherapy was delivered to the hand of the patient. He achieved satisfactory palliation in form of pain relief, control of bleeding, and discharge. The present report serves to emphasize the importance of properly diagnosing metastatic spread to unusual sites. Such metastasis is rare and is associated with a poor prognosis. Treatment is usually aimed at providing pain relief in these patients with limited life expectancy. Hence, we present a case of extensive cutaneous metastasis from laryngeal carcinoma with review of the literature.

  12. Ultrasonography findings of thyroid metastasis in a patient with hepatocellular carcinoma: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kyung Ho; Park, Noh Hyuck; Lim, Jae Hoon; Park, Chan Sub; Seong, Su Ok; Kwon, Tae Jung [Myongji Hospital, Goyang (Korea, Republic of)

    2015-03-15

    Although the thyroid gland is one of the most vascular organs of the body, metastatic disease in the thyroid is encountered infrequently. However, at autopsy, the incidence rate of thyroid metastasis ranges from 1.25% to 24%. The primary sites are the kidney, lung, breast, and gastrointestinal tract. We report a rare case of a hepatocellular carcinoma metastatic to the thyroid gland. The patient had multiple palpable masses in the anterior and left lateral neck along the internal jugular chain on physical examination 9 months after the initial diagnosis of liver tumor. These masses were confirmed as metastasis from hepatocellular carcinoma by ultrasonography-guided 16-G core needle biopsy. We discuss the sonographic findings of thyroid metastasis and their use as an additional aid for differentiating between unknown primary tumor and thyroid metastasis.

  13. Rare Presentation of Gastroesophageal Carcinoma with Rectal Metastasis: A Case Report

    Science.gov (United States)

    Makker, Jasbir; Karki, Niraj; Sapkota, Binita; Niazi, Masooma; Remy, Prospere

    2016-01-01

    Patient: Female, 60 Final Diagnosis: Gastroesophageal carcinoma with rectal metastasis Symptoms: Bloating • constipation • weight loss Medication: — Clinical Procedure: Endoscopy • flexible sigmoidoscopy • lower endoscopic ultrasound Specialty: Gastroenterology and Hepatology Objective: Unusual clinical course Background: Gastroesophageal cancers, previously considered rare, are rapidly increasing worldwide. We present here a unique case of gastroesophageal carcinoma with metastasis to the rectum. Case Report: A 60-year-old female patient presented with constipation, bloating, and weight loss of 4-month duration. She had undergone sleeve gastrectomy 6 years before. Endoscopies performed revealed a friable-looking mucosa in the lower esophagus and a polypoid rectal mass. Histopathological examination from both the esophageal and rectal lesions revealed poorly differentiated adenocarcinoma cells. Immunohistochemistry stain from both specimens was positive for CK7 supporting the gastric site primary with metastasis to the rectum. Further evaluation also revealed metastasis to bone and malignant pleural effusion. Chemotherapy with palliative intent was initiated. Conclusions: Colorectal metastasis is commonly seen from cancers of the breast, stomach, melanoma, kidney, prostate, and ovaries. However, colorectal metastasis from gastroesophageal cancer has never been reported in the medical literature. Diagnosis relies on histopathologic examination and immunohistochemical staining of the tumor. Treatment depends on the tumor stage. Tumors with widespread metastatic disease are candidates for palliative chemotherapy. PMID:27558656

  14. Factors associated with tumor response and survival in radiosurgery for brain metastasis

    International Nuclear Information System (INIS)

    We reviewed our experience with radiosurgery for brain metastasis and focused on factors associated with tumor response and survival. Our study consists of 19 patients with 25 brain metastases who underwent linear accelerator radiosurgery. There was evidence of extra-central nervous system (CNS) tumors in 15 patients. The maximum diameter of the tumors ranged from 3 to 40 mm with a mean of 20 mm. Tumor doses at the isocenter varied from 16 to 25 Gy with a mean of 21 Gy. Eighteen lesions were treated by radiosurgery alone and 7 lesions received combined radiosurgery with fractionated radiotherapy. Of the 11 patients who experienced CNS failure either in or out of the radiosurgery field, 6 patients had salvage radiotherapy. Median survival was 7 months, and the 1-year actuarial survival rate was 40%. Death was due to extra-CNS tumor manifestations in 11 patients. In 3 patients, CNS failure was the cause of death. One died of local progression, and the other 2 died of newly developed metastases. Poor Karnofsky performance scores and the presence of extra-CNS tumors significantly affected 1-year survival in univariate analysis (p<0.05). Local tumor control was achieved in 80% of the lesions. The 1-year actuarial tumor control rate was 51%. Newly developed brain metastases were observed in 7 patients. The tumor diameter was mostly associated with tumor response in multiple regression analysis (p=0.0031). We concluded that radiosurgery is effective in controlling small brain metastases. Survival benefit is expected for those with good performance status and adequately controlled extra-CNS disease. (author)

  15. BM-26CD15 AND E-SELECTIN MEDIATION OF ADHESION OF NON-SMALL CELL LUNG CANCER CELLS TO BRAIN ENDOTHELIUM IN LUNG-BRAIN METASTASIS

    OpenAIRE

    Pilkington, Geoffrey; Jassam, Samah; Maherally, Zaynah; Smith, James; Fillmore, Helen

    2014-01-01

    BACKGROUND: Lung metastases to the brain are common secondary cancers, representing over 50% of fatal complications of systemic cancer. Metastasis of cancer cells involves multiple steps including intravasation, cancer cell-endothelial rolling and adhesion, extravasation and cerebral colonization. Here, we focused on metastatic Non-Small Cell lung cancer cells adhesion to brain endothelial cells. Specifically, we investigated the role of CD15 in lung cancer and its interaction with E-selectin...

  16. Brain metastasis from non-small cell lung cancer (NSCLC). Prognostic importance of the number of involved extracranial organs

    Energy Technology Data Exchange (ETDEWEB)

    Gerdan, L. [University of Luebeck, Department of Radiation Oncology, Luebeck (Germany); University of Luebeck, Section of Nuclear Medicine, Luebeck (Germany); Segedin, B. [Institute of Oncology, Department of Radiation Oncology, Ljubljana (Slovenia); Nagy, V. [Oncology Institute Ion Ciricuta, Department of Radiotherapy, Cluj-Napoca (Romania); Khoa, M.T. [Hanoi Medical University, Department of Nuclear Medicine, Hanoi (Viet Nam); Bach Mai Hospital, Nuclear Medicine and Oncology Center, Hanoi (Viet Nam); Trang, N.T. [Bach Mai Hospital, Nuclear Medicine and Oncology Center, Hanoi (Viet Nam); Schild, S.E. [Mayo Clinic Scottsdale, Department of Radiation Oncology, Scottsdale, AZ (United States); Rades, D. [University of Luebeck, Department of Radiation Oncology, Luebeck (Germany)

    2014-01-15

    This study investigated the potential prognostic value of the number of involved extracranial organs in patients with brain metastasis from non-small cell lung cancer (NSCLC). A total of 472 patients who received whole-brain radiotherapy (WBRT) alone with 5 x 4 Gy or 10 x 3 Gy for brain metastasis from NSCLC were included in this retrospective study. In addition to the number of involved extracranial organs, 6 further potential prognostic factors were investigated including WBRT regimen, age, gender, Karnofsky Performance Score (KPS), number of brain metastases, and the interval from cancer diagnosis to WBRT. Subgroup analyses were performed for patients with metastatic involvement of one (lung vs. bone vs. other metastasis) and two (lung+bone vs. lung+lymph nodes vs. other combinations) extracranial organs. The survival rates at 6 months of the patients with involvement of 0, 1, 2, 3, and ≥4 extracranial organs were 52, 27, 17, 4, and 14%, respectively (p<0.001). On multivariate analysis, the number of involved extracranial organs remained significant (risk ratio 1.32; 95% confidence interval 1.19-1.46; p<0.001). Age <65 years (p=0.004), KPS ≥70 (p<0.001), and only 1-3 brain metastases (p=0.022) were also significantly associated with survival in the multivariate analysis. In the separate analyses of patients with involvement of one and two extracranial organs, survival was not significantly different based on the pattern of extracranial organ involvement. The number of involved extracranial organs is an independent prognostic factor of survival in patients with brain metastasis from NSCLC, irrespective of the pattern of extracranial organ involvement. (orig.)

  17. Brain metastasis from non-small cell lung cancer (NSCLC). Prognostic importance of the number of involved extracranial organs

    International Nuclear Information System (INIS)

    This study investigated the potential prognostic value of the number of involved extracranial organs in patients with brain metastasis from non-small cell lung cancer (NSCLC). A total of 472 patients who received whole-brain radiotherapy (WBRT) alone with 5 x 4 Gy or 10 x 3 Gy for brain metastasis from NSCLC were included in this retrospective study. In addition to the number of involved extracranial organs, 6 further potential prognostic factors were investigated including WBRT regimen, age, gender, Karnofsky Performance Score (KPS), number of brain metastases, and the interval from cancer diagnosis to WBRT. Subgroup analyses were performed for patients with metastatic involvement of one (lung vs. bone vs. other metastasis) and two (lung+bone vs. lung+lymph nodes vs. other combinations) extracranial organs. The survival rates at 6 months of the patients with involvement of 0, 1, 2, 3, and ≥4 extracranial organs were 52, 27, 17, 4, and 14%, respectively (p<0.001). On multivariate analysis, the number of involved extracranial organs remained significant (risk ratio 1.32; 95% confidence interval 1.19-1.46; p<0.001). Age <65 years (p=0.004), KPS ≥70 (p<0.001), and only 1-3 brain metastases (p=0.022) were also significantly associated with survival in the multivariate analysis. In the separate analyses of patients with involvement of one and two extracranial organs, survival was not significantly different based on the pattern of extracranial organ involvement. The number of involved extracranial organs is an independent prognostic factor of survival in patients with brain metastasis from NSCLC, irrespective of the pattern of extracranial organ involvement. (orig.)

  18. A case of metastasis-induced acute pancreatitis in a patient with small cell lung cancer

    OpenAIRE

    Yamanashi, Keiji; Marumo, Satoshi; Saitoh, Motoh; Kato, Motokazu

    2014-01-01

    Key Clinical Message We report a rare case of metastasis-induced acute pancreatitis (MIAP) from small cell lung cancer (SCLC) diagnosed on autopsy, indicating a diagnosis of MIAP with SCLC. Our case suggests that MIAP can arise as a complication of SCLC and has an extremely poor prognosis.

  19. Squamous cell carcinoma of the pancreas with liver metastasis: a case report

    Institute of Scientific and Technical Information of China (English)

    CHEN Qiang-pu; OU Kun; GUAN Qing-hai; ZHANG Fan

    2008-01-01

    @@ Squamous cell carcinoma of the pancreas is an unusual cancer of ductal cell origin. In a review of 6668 cases of exocrine pancreatic cancer from various registries reported from 1950 through 1985, the incidence of squamous carcinoma and adenosquamous carcinoma was 0.005% and 0.01%, respectively.1 We report a case of squamous cell carcinoma of the pancreas with liver metastasis.

  20. Skull Metastasis as Initial Manifestation of Pulmonary Epithelial-Myoepithelial Carcinoma: A Case Report of an Unusual Case

    OpenAIRE

    Masamitsu Nishihara; Naoya Takeda; Shoutarou Tatsumi; Keiji Kidoguchi; Shigeto Hayashi; Takashi Sasayama; Eiji Kohmura; Kimio Hashimoto

    2011-01-01

    Epithelial-myoepithelial carcinoma (EMC) of the lung is rare and is considered to be low-grade malignancy. Intracranial metastasis of pulmonary EMC has not previously been reported according to our search of the literature. We report a case of skull metastasis as the initial manifestation of pulmonary EMC. An 81-year-old man complained of left leg motor weakness. Neurological examination showed left hemiparesis. Computed tomography and magnetic resonance imaging revealed an osteolytic tumor i...

  1. Tumor pseudoprogression of spinal metastasis after radiosurgery: a novel concept and case reports.

    Science.gov (United States)

    Taylor, Douglas R; Weaver, Jason A

    2015-05-01

    Radiosurgery for primary and metastatic tumors of the central nervous system is increasing in utility and intensity. Known complications in the brain include radiation necrosis and the well-documented phenomenon of pseudoprogression. Known complications of radiosurgery to spinal column tumors include radiation myelopathy and delayed vertebral compression fractures; however, the concept of pseudoprogression of spinal column tumors has not been previously described. The authors review 2 cases of spinal metastasis treated with stereotactic radiosurgery (SRS) and attempt to define the concept of spine tumor pseudoprogression. Two patients who had undergone SRS to the spine for metastatic disease presented in early follow-up (3 and 7 weeks) with symptomatic complaints consisting of axial pain, radicular pain, or evidence of cord compression. In both patients, MRI revealed evidence of tumor enlargement. In one patient, the lesion had grown by 9 mm and 7.7 mm in the axial and sagittal planes, respectively. In the other patient, the tumor growth resulted in a 5-mm decrease in spinal canal diameter with epidural compression and right foraminal encroachment. Because of the absence of progressive neurological deficit, myelopathy, mechanical symptomatology of instability, or vertebral compression fracture, the first patient was treated expectantly with a corticosteroid taper and had improvement of symptoms at 1 month and near-total radiographic resolution of the tumor. In the second patient, worsening symptoms suggested a need for surgical intervention to address presumed radiosurgical failure and tumor progression. During surgery, only necrotic tumor cells were observed, without viable tumor. Follow-up imaging over 1 year showed ongoing local control. To their knowledge, the authors report the first description of pseudoprogression involving spinal column metastasis in the literature and aim to alert the treating physician to this clinical situation. Unlike brain tumor

  2. Subcutaneous metastasis in medulloblastoma: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Tanmoy Maiti

    2013-01-01

    Full Text Available Extraneural metastasis (ENM in patients with medulloblastoma is a rare but a well-described phenomenon, both in children and adults. Most of the ENM involve bone and bone marrow and rarely involve other solid organs. Subcutaneous and muscular metastasis is an extremely rare event, more so in children, with only two cases documented in the pediatric population. We describe a case of medulloblastoma with ENM in right masseter and subcutaneous plane along with concomitant central nervous system relapse, 4 years after the primary diagnosis, with a brief review of the literature.

  3. Isolated cutaneous metastasis of uterine leiomyosarcoma: case report and review of literature

    LENUS (Irish Health Repository)

    Corcoran, Shane

    2012-07-18

    AbstractA 54 year old lady presented for routine excision of a scalp lesion thought clinically to represent a sebaceous cyst of the right occiput. 4 years earlier she underwent total abdominal hysterectomy and right salpingo-oophorectomy for 3 large uterine fibroids. Histo-pathological examination of the hysterectomy specimen revealed an incidental low-grade leiomyosarcoma. Staging imaging was negative for metastatic disease. She made an uneventful recovery and was treated further by adjuvant pelvic radiotherapy.She noticed an uncomfortable and unsightly cystic swelling on her occiput four years after hysterectomy and was referred for routine excision of what was believed to be a benign lesion. The lesion was excised and sent for histopathological examination. Microscopic analysis including immuno-histochemistry demonstrated an ER and PR positive metastatic deposit of leiomyosarcoma. The margins of excision were histologically clear of disease.At Multi-Disciplinary Team (MDT) discussion a diagnosis of metastatic scalp deposit from previous uterine leiomyosarcoma was made. Re-staging CT brain, thorax, abdomen and pelvis and MRI brain were negative for local recurrence or distant metastases. She is currently undergoing radiotherapy to the scalp and surrounding tissues and will be followed up closely by the involved teams.To the best of our knowledge, this is the first case described in the worldwide literature of isolated cutaneous metastasis to the scalp of uterine leiomyosarcoma without evidence of disseminated disease at other sites.Virtual slidesThe virtual slide(s) for this article can be found here: http:\\/\\/www.diagnosticpathology.diagnomx.eu\\/vs\\/1311834987345566.

  4. Metastasis to the penis in a patient with adenocarcinoma of lung, case report and literature review.

    Science.gov (United States)

    Zheng, Fu-Fu; Zhang, Zhong-Yun; Dai, Yu-Ping; Liang, Yue-You; Deng, Chun-Hua; Tao, Yu

    2009-01-01

    Metastasis of lung cancer to the penis is very rare; it causes various clinical symptoms seriously affecting the quality of life. Early recognition and appropriate management will likely enhance survival in these patients. Here, we report a case of penile metastasis secondary to pulmonary carcinoma along with a review of the literature. One case of penile metastasis secondary to pulmonary carcinoma was detected in a 51-year-old patient who was admitted to the First Affiliated Hospital of Sun Yat-Sen University with persistent cough along with swelling of the perineum and penis. The clinical features, diagnosis, and treatment of this disease along with a relevant literature are reviewed and discussed. A MEDLINE search was performed to identify similar reports in the literature. CT scan revealed lung mass, and a glans penis ulcer and enlargement of inguinal lymph nodes was discovered upon physical examination. CT-guided percutaneous puncture of the lung mass revealed adenocarcinoma of lung, and biopsies of the glans penis ulcer and inguinal lymph nodes confirmed metastatic adenocarcinoma. The patients received chemotherapy and died of acute pulmonary embolism in less than 2 months. Metastasis of lung cancer to the penis is extremely rare. It presents an advanced form of lung cancer, and thus survival is extremely short. Although treatment of penile metastasis is almost always palliative, early recognition may enhance survival for these patients. PMID:18975150

  5. A Rare Case of Pulmonary Epithelioid Hemangioendothelioma Presenting with Skin Metastasis

    Science.gov (United States)

    Ro, Hyung-Suk; Roh, Si-Gyun; Lee, Nae-Ho; Yang, Kyung-Moo; Moon, Woo-Sung

    2016-01-01

    Epithelioid hemangioendothelioma (EHE) is a well-differentiated and rare vascular tumor. Systemic metastases are uncommon. Herein, we present a patient with skin metastasis of pulmonary EHE (PEH) that was treated by wide excision. A 76-year-old male was evaluated due to pulmonary thromboembolism and a solitary pulmonary nodule. A biopsy was performed and pathological examination of the mass confirmed EHE. No metastasis was observed. The patient returned to care approximately two years later due to a painful nodule in the right lower leg. A skin biopsy showed metastatic EHE from the lung. We used a safety margin of 1 cm based on clinical experience, because no prior case had been reported regarding the resection margin appropriate for primary cutaneous EHE and skin metastases of PEH. At four months after surgery, the patient recovered without complications or recurrence. Skin metastasis of PEH is extremely rare, and only two cases have been reported in the literature. In this case, we report a rare case of PEH with histologically diagnosed skin metastasis that was successfully treated by curative resection. It is expected that this case report will provide a helpful contribution to the extant data regarding PEH metastases. PMID:27218028

  6. Brain metastasis of gynecologic tumors. Experience in the laboratory of neuropathology in a period of 5 years (1998-2003). Clinical Hospital Dr. Manuel Quintela, Montevideo Uruguay

    International Nuclear Information System (INIS)

    Intracranial metastases occur in 13.5 to 37% of patients with cancer spread, the most common primary sites lung, breast, kidney and gastrointestinal tract. Gynecologic malignancies rarely give brain metastases, with the exception of choriocarcinoma. The incidence of metastasis ovarian carcinomas brain varies between 0.9 and 3.3%, although figures are increasing due to improved survival with treatment chemotherapy and early detection of lesions. Secondly, figures of between 0.4 and 1.2% are metastases cervix. They are usually poorly differentiated tumors with disease advanced locoregional and disseminated systemic disease. carcinomas endometrium are less common, with an incidence of 0.3%. Generally have widely disseminated disease.The purpose of this study is to document the occurrence of brain metastases gynecologic origin in the Laboratory of Neuropathology of the Clinical Hospital between 1998 and 2003 In this period 273 cases were studied brain metastases of whom 4.7% (n = 13) had a primitive gynecological. Of these 38.4% were for ovarian primitive, 30.7% a primitive cervical and 30.7% to a primitive endometrium. Analyzed clinical features, the topography of the lesions and histological type. While metastases from gynecologic tumors are rare, should be considered patients with one or more brain mass, even in those cases where primary disease is unknown

  7. Integrating Structure to Protein-Protein Interaction Networks That Drive Metastasis to Brain and Lung in Breast Cancer

    OpenAIRE

    H Billur Engin; Emre Guney; Ozlem Keskin; Baldo Oliva; Attila Gursoy

    2013-01-01

    Integrating Structure to Protein-Protein Interaction Networks That Drive Metastasis to Brain and Lung in Breast Cancer H. Billur Engin1, Emre Guney2, Ozlem Keskin1, Baldo Oliva2, Attila Gursoy1* 1 Center for Computational Biology and Bioinformatics and College of Engineering, Koc University, Istanbul, Turkey, 2 Structural Bioinformatics Group (GRIB), Universitat Pompeu Fabra Abstract Blocking specific protein interactions can lead to human diseases. Accordingly, protein i...

  8. Integrating structure to protein-protein interaction networks that drive metastasis to brain and lung in breast cancer

    OpenAIRE

    Engin, H Billur; G??ney, Emre, 1983-; Keskin, Ozlem; Oliva Miguel, Baldomero; Gursoy, Attila

    2013-01-01

    Integrating Structure to Protein-Protein Interaction Networks That Drive Metastasis to Brain and Lung in Breast Cancer H. Billur Engin1, Emre Guney2, Ozlem Keskin1, Baldo Oliva2, Attila Gursoy1* 1 Center for Computational Biology and Bioinformatics and College of Engineering, Koc University, Istanbul, Turkey, 2 Structural Bioinformatics Group (GRIB), Universitat Pompeu Fabra Abstract Blocking specific protein interactions can lead to human diseases. Accordingly, protein i...

  9. Radiotherapy in different doses for non-small cell lung cancer patients with brain metastasis-phase I-II study

    International Nuclear Information System (INIS)

    Objective: To observe the tolerance, effectiveness and prognostic factors of three different doses for non-small cell lung cancer (NSCLC) patients with brain metastasis. Methods: Seventy-five NSCLC patients with known brain metastasis were irradiated in the following protocols. Group A whole brain irradiation to 30 Gy/10 fractions over 2 weeks then boosted to 45 Gy/15 fractions over 3 weeks for patients with only one lesion in the brain without any extracranial involvement (14 cases). Group B whole irradiation to 39 Gy/13 fractions over 2.5 weeks for patients with more than one lesion in the brain also without any extracranial involvement (29 cases). Group C whole irradiation to 30 Gy/10 fractions over 2 weeks for patients with both extracranial and brain lesions (32 cases). Results: The incidence of symptom relief (pain, nausea and vomiting) was 100% in all groups. The incidences of neurological sign relief in groups A,B,C were 100%(7/7), 86%(12/14), 93%(14/15). The overall median local control duration was 7.6 months (0.8-52.7 months). The overall 1-and 2-year local control rates were 46% and 23%. The 1-and 2-year local control rates of groups A, B, C were 55% and 38%, 52% and 26%, 33% and 10%, respectively. The overall median survival was 9.6 months (0.8-52.8 months). The overall 1-and 2-year survival rates were 49% and 26%. The 1-and 2-year survival rates of groups A, B, C were 53% and 49%, 50% and 23%, 45% and 9%, respectively. Side effects: None of these patients showed serious acute side effects except one in group A who developed gastrointestinal bleeding and one in group C who had epileptic seizures during the second session of irradiation. Late effects: Two patients in group B showed impairment in thought coherence and behavior though without any tumor in the brain after 23, 17 months of irradiation. The results of Cox regression in local control suggested that higher dose may give better local control duration (P=0.003). And another result of Cox

  10. Low Expression of Slit2 and Robo1 is Associated with Poor Prognosis and Brain-specific Metastasis of Breast Cancer Patients

    OpenAIRE

    Fengxia Qin; Huikun Zhang; Li Ma; Xiaoli Liu; Kun Dai; Wenliang Li; Feng Gu; Li Fu; Yongjie Ma

    2015-01-01

    Brain metastasis is a significant unmet clinical problem in breast cancer treatment. It is always associated with poor prognosis and high morbidity. Recently, Slit2/Robo1 pathway has been demonstrated to be involved in the progression of breast carcinoma. However, until present, there are no convincing reports that suggest whether the Slit2/Robo1 axis has any role in brain metastasis of breast cancer. In this study, we investigated the correlation between Slit2/Robo1 signaling and breast canc...

  11. Short-time focused ultrasound hyperthermia enhances liposomal doxorubicin delivery and antitumor efficacy for brain metastasis of breast cancer.

    Science.gov (United States)

    Wu, Sheng-Kai; Chiang, Chi-Feng; Hsu, Yu-Hone; Lin, Tzu-Hung; Liou, Houng-Chi; Fu, Wen-Mei; Lin, Win-Li

    2014-01-01

    The blood-brain/tumor barrier inhibits the uptake and accumulation of chemotherapeutic drugs. Hyperthermia can enhance the delivery of chemotherapeutic agent into tumors. In this study, we investigated the effects of short-time focused ultrasound (FUS) hyperthermia on the delivery and therapeutic efficacy of pegylated liposomal doxorubicin (PLD) for brain metastasis of breast cancer. Murine breast cancer 4T1-luc2 cells expressing firefly luciferase were injected into female BALB/c mice striatum tissues and used as a brain metastasis model. The mice were intravenously injected with PLD (5 mg/kg) with/without 10-minute transcranial FUS hyperthermia on day 6 after tumor implantation. The amounts of doxorubicin accumulated in the normal brain tissues and tumor tissues with/without FUS hyperthermia were measured using fluorometry. The tumor growth for the control, hyperthermia, PLD, and PLD + hyperthermia groups was measured using an IVIS spectrum system every other day from day 3 to day 11. Cell apoptosis and tumor characteristics were assessed using immunohistochemistry. Short-time FUS hyperthermia was able to significantly enhance the PLD delivery into brain tumors. The tumor growth was effectively inhibited by a single treatment of PLD + hyperthermia compared with both PLD alone and short-time FUS hyperthermia alone. Immunohistochemical examination further demonstrated the therapeutic efficacy of PLD plus short-time FUS hyperthermia for brain metastasis of breast cancer. The application of short-time FUS hyperthermia after nanodrug injection may be an effective approach to enhance nanodrug delivery and improve the treatment of metastatic cancers. PMID:25278753

  12. Short-time focused ultrasound hyperthermia enhances liposomal doxorubicin delivery and antitumor efficacy for brain metastasis of breast cancer

    Science.gov (United States)

    Wu, Sheng-Kai; Chiang, Chi-Feng; Hsu, Yu-Hone; Lin, Tzu-Hung; Liou, Houng-Chi; Fu, Wen-Mei; Lin, Win-Li

    2014-01-01

    The blood–brain/tumor barrier inhibits the uptake and accumulation of chemotherapeutic drugs. Hyperthermia can enhance the delivery of chemotherapeutic agent into tumors. In this study, we investigated the effects of short-time focused ultrasound (FUS) hyperthermia on the delivery and therapeutic efficacy of pegylated liposomal doxorubicin (PLD) for brain metastasis of breast cancer. Murine breast cancer 4T1-luc2 cells expressing firefly luciferase were injected into female BALB/c mice striatum tissues and used as a brain metastasis model. The mice were intravenously injected with PLD (5 mg/kg) with/without 10-minute transcranial FUS hyperthermia on day 6 after tumor implantation. The amounts of doxorubicin accumulated in the normal brain tissues and tumor tissues with/without FUS hyperthermia were measured using fluorometry. The tumor growth for the control, hyperthermia, PLD, and PLD + hyperthermia groups was measured using an IVIS spectrum system every other day from day 3 to day 11. Cell apoptosis and tumor characteristics were assessed using immunohistochemistry. Short-time FUS hyperthermia was able to significantly enhance the PLD delivery into brain tumors. The tumor growth was effectively inhibited by a single treatment of PLD + hyperthermia compared with both PLD alone and short-time FUS hyperthermia alone. Immunohistochemical examination further demonstrated the therapeutic efficacy of PLD plus short-time FUS hyperthermia for brain metastasis of breast cancer. The application of short-time FUS hyperthermia after nanodrug injection may be an effective approach to enhance nanodrug delivery and improve the treatment of metastatic cancers. PMID:25278753

  13. Penile metastasis secondary to bladder cancer: A report of two cases

    Directory of Open Access Journals (Sweden)

    Narendra Kumar

    2014-01-01

    Full Text Available Penile metastasis secondary to primary bladder cancer is a rare entity and represents a challenging problem. The common mode of spread to the penis is by retrograde venous route. The overall outcome is dismal and most patients will die within 1 year even after optimum treatment. Here, we report two such cases.

  14. Penile Metastasis Secondary to Bladder Cancer: A Report of Two Cases

    OpenAIRE

    Narendra Kumar; Tapesh Bhattacharyya; Mandal, A K; Nalini Gupta; A Rajwanshi; Ritesh Kumar

    2014-01-01

    Penile metastasis secondary to primary bladder cancer is a rare entity and represents a challenging problem. The common mode of spread to the penis is by retrograde venous route. The overall outcome is dismal and most patients will die within 1 year even after optimum treatment. Here, we report two such cases.

  15. Isolated omental metastasis of renal cell carcinoma after extraperitoneal open partial nephrectomy: A case report

    Directory of Open Access Journals (Sweden)

    Ömer Acar

    2016-01-01

    Conclusion: To our knowledge, this is the first reported case of metachronously developed, isolated omental metastasis of an initially T1 clear-cell RCC. Constitutional symptoms, despite a long interval since nephrectomy, should raise the possibility of a paraneoplastic syndrome being associated with metastatic RCC. Morphological and molecular imaging studies together with histopathological documentation will be diagnostic.

  16. Atypical primary pulmonary meningioma: a report of a case suspected of being a lung metastasis

    OpenAIRE

    Lepanto, Daniela; Maffini, Fausto; Petrella, Francesco; Colandrea, Marzia; Putzu, Carlo; Barberis, Massimo; Paganelli, Giovanni; Viale, Giuseppe

    2014-01-01

    Primary extracranial and extraspinal meningiomas are very rare tumours, and primary pulmonary ones are even more uncommon. They present as a solitary pulmonary nodule, and most of them are benign, except for three cases. We describe a primitive atypical pulmonary meningioma first suspected of being a metastasis in a patient during follow-up ten years after therapy for breast cancer.

  17. Cholangiocarcinoma presenting as a solitary epididymal metastasis: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Bailey David M

    2007-08-01

    Full Text Available Abstract Background Solid tumor metastasis to the epididymis is a rare occurrence and is mostly discovered incidentally at autopsy or after therapeutic orchidectomy for prostate cancer. Other primary carcinomas that have been demonstrated to metastasize to the paratesticular region include those originating in the stomach, kidney, ileum, and colon. Case presentation A 72-year-old gentleman presented with a firm and tender mass involving the right epididymis. On examination, he was jaundiced. Computed tomography of the abdomen demonstrated an obstructive stricture of the extra-hepatic bile ducts, in keeping with a cholangiocarcinoma, through which a metal stent was endoscopically inserted for symptomatic relief. Subsequent right radical orchidectomy yielded a diffusely infiltrative adenocarcinoma obliterating the epididymis, extending into the rete testis, vas deferens and spermatic cord and showing widespread vascular and perineural invasion. Residual epididymal, rete, and testicular tubules showed no in situ neoplasia. Morphologically and immunohistochemically the features were in keeping with a metastasis from a primary cholangiocarcinoma. Conclusion Only two cases of bile duct carcinoma metastasising to the male genital tract have previously been reported in the literature, the testis being the main site of metastasis in both cases. To our knowledge, this is the first described case of cholangiocarcinoma metastasising primarily to the epididymis, and presenting as a solitary epididymal metastasis in the absence of disseminated disease. It serves to highlight the importance of performing a thorough examination of the male external genitalia both clinically, in the follow up of cancer patients, and at autopsy.

  18. Urethral metastasis from non-seminomatous germ cell tumor: a case report

    Directory of Open Access Journals (Sweden)

    Joffe Johnathan

    2011-01-01

    Full Text Available Abstract Introduction We present a case of nonseminomatous germ cell tumor of the testes with acute urinary retention secondary to urethral metastasis. This presentation, and similar cases of urethral metastasis from this tumor, have not been reported previously. Case presentation A 35-year-old Caucasian man presented to hospital with a history of acute urinary retention. On examination he was found to have right testicular enlargement with raised β-human chorionic gonadotrophin, serum α-fetoprotein and lactate dehydrogenase levels. He underwent radical left inguinal orchidectomy and histology confirmed a nonseminomatous germ cell tumor of the testes. Cystoscopy carried out due to urinary retention showed penile metastasis and the biopsy confirmed metastatic malignant undifferentiated teratoma. Staging computed tomography scan and magnetic resonance imaging of the pelvis showed pulmonary, pelvic nodal, ischial and penile metastasis. The diagnosis of the International Germ Cell Cancer Collaborative Group of poor prognosis metastatic nonseminomatous germ cell tumor was made, following which he received four cycles of bleomycin, etoposide and cisplatin chemotherapy with curative intent. He had a complete marker and an excellent radiological response. He is currently under follow up. Conclusion The unusual presentation of lymphovascular spread in this case of nonseminomatous germ cell tumor highlights the need to include routine pelvic imaging in the assessment and follow up of testicular cancer.

  19. Intracranial Dural Metastasis of Ewing's Sarcoma: a Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eung Yeop; Lee, Seung Koo; Kim, Dong Joon; Kim, Jin Na; Lee, Kyu Sung; Jung, Woo Hee; Kim, Dong Ik [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2008-02-15

    Ewing's sarcoma is a malignant bone tumor that can occur anywhere in the body, but it is most commonly observed in the long bones of the arms and legs, the pelvis and in the chest. The predominant sites of metastasis include the lung (38%), bone (including the spine; 31%), and the bone marrow (11%). Metastasis of Ewing's sarcoma to the central nervous system (CNS) is relatively rare, and most of the previous reports have demonstrated involvement of the bony calvarium or brain parenchyma. We describe here the imaging findings of dural metastasis of Ewing's sarcoma, and these imaging findings have not been previously reported on in the medical literature. In conclusion, dural metastasis of Ewing's sarcoma is very rare and its imaging characteristics are similar to those of a primary tumor, which mimic the findings of a schwannoma or meningioma. Despite its rarity, secondary Ewing's sarcoma may be included in the differential diagnosis of extra-axial dural masses.

  20. Cytodiagnosis of cutaneous metastasis from renal cell carcinoma: A case report with review of literature

    Directory of Open Access Journals (Sweden)

    Vishal Dhingra

    2011-01-01

    Full Text Available Cytodiagnosis of cutaneous metastasis of renal cell carcinoma (RCC in the absence of history of primary tumor is difficult as it can be confused with other clear cell tumors. We report here a case of cytodiagnosis of cutaneous metastasis of RCC in a patient who had nephrectomy done 9 years back at some other centre, but did not have any records with him. Clinicians should be aware of the possibility of primary internal organ malignancy in patients presenting with cutaneous lesions and therefore conduct a careful examination and get necessary investigations. Prompt diagnosis and treatment will have its bearing on the eventual outcome.

  1. Inhibition of Type I Insulin-Like Growth Factor Receptor Signaling Attenuates the Development of Breast Cancer Brain Metastasis

    OpenAIRE

    Saldana, Sandra M.; Lee, Heng-Huan; Lowery, Frank J; Khotskaya, Yekaterina B.; Xia, Weiya; Zhang, Chenyu; Chang, Shih-Shin; Chou, Chao-Kai; Steeg, Patricia S; Yu, Dihua; Hung, Mien-Chie

    2013-01-01

    Brain metastasis is a common cause of mortality in cancer patients, yet potential therapeutic targets remain largely unknown. The type I insulin-like growth factor receptor (IGF-IR) is known to play a role in the progression of breast cancer and is currently being investigated in the clinical setting for various types of cancer. The present study demonstrates that IGF-IR is constitutively autophosphorylated in brain-seeking breast cancer sublines. Knockdown of IGF-IR results in a decrease of ...

  2. Efficacy of concurrent chemoradiotherapy in cases with cervical lymph node metastasis from oropharyngeal or hypopharyngeal cancer

    International Nuclear Information System (INIS)

    We reported the efficacy of concurrent chemoradiotherapy(CCRT) for cervical lymph node metastasis in patients with oropharyngeal or hypopharyngeal squamous cell carcinoma. The subjects were 17 patients with oropharyngeal or hypopharyngeal cancer with cervical lymph node metastasis, who underwent CCRT treatment between January 2005 and December 2009. The proportion of patients showing a complete response (CR) was 64.7%; however, if patients without any residual viable cancer cells in the specimens obtained by neck dissection were also defined as CR, then, 82.4% achieved CR. Thus, CCRT showed good efficacy without the need for planned neck dissection (PND). The limited recurrence cases and absence of serious complications associated with neck dissection after CCRT suggested that PND is not necessarily required. However, since assessment of cervical lymph nodes after CCRT is difficult, it would be desirable to develop a reliable examination and to study the most suitable examination for detecting the presence/absence of cervical lymph node metastasis. (author)

  3. TTF-1 may not be a Reliable Marker for Differentiating Metastasis from Brain Tumors

    Directory of Open Access Journals (Sweden)

    Betül ÜNAL

    2014-09-01

    Full Text Available Objective: TTF-1 is widely used as an immunohistochemical marker of lung and thyroid tumors. However, TTF-1 expression has been described in tumors from other sites. The presence of TTF-1 expression in primary brain tumors is largely unclear and has not been clearly specified yet. We characterized expression of two TTF-1 clones in primary brain tumors with relevance to tumor types and grades. Material and Method: We studied immunohistochemistry with tissue micro-array, using both clones (8G7G3/1 and SPT24 in 45 primary brain tumors of different types and grades. Our cases consisted of 1 grade I, 7 grade II, 4 grade III, 20 grade IV astrocytic tumors; 9 meningiomas, 2 oligodendrogliomas, 1 schwannoma and 1 medulloblastoma. Results: We have found TTF-1 nuclear staining using the SPT24 clone in 4 cases (3 cases were grade IV and 1 was grade III. Focal and weak staining was seen in three cases and moderate-strong and diffuse staining was seen in one case. All the tumors were negative with clone 8G7G3/1. Clone SPT24 was more sensitive but less specific. Conclusion: TTF-1 can also be expressed in primary brain tumors, particularly grade III to IV tumors. TTF-1 expression was a rare finding in previous studies, however strong and diffuse staining was not observed until today. We think that TTF-1 nuclear expression in high-grade astrocytic tumors cannot rule out primaries even when diffuse and strong staining. Clinical and pathological parameters should be evaluated together.

  4. Two cases of gastrointestinal stromal tumor of the small intestine with liver and bone metastasis.

    Science.gov (United States)

    Aktan, Meryem; Koc, Mehmet; Yavuz, Berrin Benli; Kanyilmaz, Gul

    2015-10-01

    Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. These tumors most commonly occur in the stomach (60%), jejunum and ileum (30%). Metastasis is characteristically the malignant behavior of the GISTs. GISTs most frequently metastasize to the liver and peritoneum, whereas bone and lung metastases are uncommon sites. Here, we described two cases of bone and liver metastases in patients with advanced GISTs. Both of them showed liver metastasis at disease presentation and bone metastasis in early time after the diagnosis. Bone metastases involved the lumber spine and right femur in first patient and L2 vertebral body in the second case. All of the lesions presented a lytic pattern. These cases are presented because of the rare incidence of bone metastasis to femur and vertebral bodies. More attention should be paid to the diagnosis of bone metastases from GISTs in clinical practice despite the shortage of available data on the sensitivity and specificity of bone scintigraphy and PET-CT. PMID:26605305

  5. Short-time focused ultrasound hyperthermia enhances liposomal doxorubicin delivery and antitumor efficacy for brain metastasis of breast cancer

    Directory of Open Access Journals (Sweden)

    Wu SK

    2014-09-01

    Full Text Available Sheng-Kai Wu,1 Chi-Feng Chiang,1 Yu-Hone Hsu,1,4 Tzu-Hung Lin,2 Houng-Chi Liou,2 Wen-Mei Fu,2 Win-Li Lin1,3 1Institute of Biomedical Engineering, College of Medicine and College of Engineering, 2Institute of Pharmacology, College of Medicine, National Taiwan University, Taipei, Taiwan; 3Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Miaoli, Taiwan; 4Department of Neurosurgery, Cheng-Hsin General Hospital, Taipei, Taiwan Abstract: The blood–brain/tumor barrier inhibits the uptake and accumulation of chemotherapeutic drugs. Hyperthermia can enhance the delivery of chemotherapeutic agent into tumors. In this study, we investigated the effects of short-time focused ultrasound (FUS hyperthermia on the delivery and therapeutic efficacy of pegylated liposomal doxorubicin (PLD for brain metastasis of breast cancer. Murine breast cancer 4T1-luc2 cells expressing firefly luciferase were injected into female BALB/c mice striatum tissues and used as a brain metastasis model. The mice were intravenously injected with PLD (5 mg/kg with/without 10-minute transcranial FUS hyperthermia on day 6 after tumor implantation. The amounts of doxorubicin accumulated in the normal brain tissues and tumor tissues with/without FUS hyperthermia were measured using fluorometry. The tumor growth for the control, hyperthermia, PLD, and PLD + hyperthermia groups was measured using an IVIS spectrum system every other day from day 3 to day 11. Cell apoptosis and tumor characteristics were assessed using immunohistochemistry. Short-time FUS hyperthermia was able to significantly enhance the PLD delivery into brain tumors. The tumor growth was effectively inhibited by a single treatment of PLD + hyperthermia compared with both PLD alone and short-time FUS hyperthermia alone. Immunohistochemical examination further demonstrated the therapeutic efficacy of PLD plus short-time FUS hyperthermia for brain metastasis of breast cancer. The

  6. A clinical case of the penile metastasis from the rectal carcinoma

    OpenAIRE

    Yildirim, Mehmet; Coskun, Ali; Pürten, Mete; Oztekin, Ozgur; Ilhan, Enver

    2010-01-01

    Background Penile metastases are rare and usually secondary to genitourinary and colorectal cancer. Case report We present a case of a 77-year-old man with penile metastasis who was operated for rectal carcinoma. He was referred to our clinic for penile ulcerous lesion, semierectile penis and voiding dysfunction. Imaging studies showed nodular lesion at glans penis and multiple bone metastases. He did not respond to chemoradiotherapy and he had bad prognosis. Conclusions Imaging methods and b...

  7. A Case of Sweet's Panniculitis Associated with Spinal Metastasis from Prostate Cancer

    OpenAIRE

    Kim, Jihyun; Choi, Yoon Jin; Oh, Sang Ho; Lee, Kwang Hoon

    2010-01-01

    Sweet's panniculitis is a rare variant of Sweet's syndrome in which neutrophilic infiltrate can be found either in the subcutaneous fat or in both the dermis and the subcutaneous tissue. Due to the rarity of this entity, the association between Sweet's panniculitis and malignancies is inconclusive, but cases of Sweet's panniculitis have largely been associated with hematological malignancies. Herein, we present a case of Sweet's panniculitis accompanied by bone metastasis from prostate cancer...

  8. Cavernous mesenteric lymphangiomatosis mimicking metastasis in a patient with rectal cancer: A case report

    Institute of Scientific and Technical Information of China (English)

    Seong Su Hwang; Hyun Joo Choi; Soo Youn Park

    2009-01-01

    Lymphangioma usually occurs in children and usually involves the skin. Mesenteric lymphangioma is extremely rare in adults. Typically, lymphangioma appears on computed tomography (CT) as a lower attenuation of a cystic mass, however, some cases appear to be a solid mass. We describe the CT and 18FFDG positron emission tomography/CT appearance in a case of jejunal and mesenteric cavernous lymphangiomatosis mimicking metastasis in an adult patient with rectal cancer.

  9. Clear cell carcinoma arising from abdominal wall endometriosis: a unique case with bladder and lymph node metastasis

    OpenAIRE

    Liu, Haiyuan; Leng, Jinghua; Lang, Jinghe; Cui, Quancai

    2014-01-01

    The malignant transformation of abdominal wall endometriosis is a rare event and poorly understood. Less than 30 cases have been reported in the literature. Most of the reported cases have a solitary tumor in the abdominal scar. A few cases have metastasis. Here we report a case of clear cell carcinoma in abdominal wall endometriosis with bladder and lymph system metastasis. The patient had a history of abdominal wall endometriosis and recently developed symptoms of urgent urination and ingui...

  10. SNPs in the TGF-β signaling pathway are associated with increased risk of brain metastasis in patients with non-small-cell lung cancer.

    Directory of Open Access Journals (Sweden)

    Qianxia Li

    Full Text Available PURPOSE: Brain metastasis (BM from non-small cell lung cancer (NSCLC is relatively common, but identifying which patients will develop brain metastasis has been problematic. We hypothesized that genotype variants in the TGF-β signaling pathway could be a predictive biomarker of brain metastasis. PATIENTS AND METHODS: We genotyped 33 SNPs from 13 genes in the TGF-β signaling pathway and evaluated their associations with brain metastasis risk by using DNA from blood samples from 161 patients with NSCLC. Kaplan-Meier analysis was used to assess brain metastasis risk; Cox hazard analyses were used to evaluate the effects of various patient and disease characteristics on the risk of brain metastasis. RESULTS: The median age of the 116 men and 45 women in the study was 58 years; 62 (39% had stage IIIB or IV disease. Within 24 months after initial diagnosis of lung cancer, brain metastasis was found in 60 patients (37%. Of these 60 patients, 16 had presented with BM at diagnosis. Multivariate analysis showed the GG genotype of SMAD6: rs12913975 and TT genotype of INHBC: rs4760259 to be associated with a significantly higher risk of brain metastasis at 24 months follow-up (hazard ratio [HR] 2.540, 95% confidence interval [CI] 1.204-5.359, P = 0.014; and HR 1.885, 95% CI 1.086-3.273, P = 0.024, compared with the GA or CT/CC genotypes, respectively. When we analyzed combined subgroups, these rates showed higher for those having both the GG genotype of SMAD6: rs12913975 and the TT genotype of INHBC: rs4760259 (HR 2.353, 95% CI 1.390-3.985, P = 0.001. CONCLUSIONS: We found the GG genotype of SMAD6: rs12913975 and TT genotype of INHBC: rs4760259 to be associated with risk of brain metastasis in patients with NSCLC. This finding, if confirmed, can help to identify patients at high risk of brain metastasis.

  11. Incidence, symptoms, treatment, and prognosis in 113 patients with brain/meningeal metastasis from breast cancer. Screening in accordance with hormone receptor and HER2/neu

    International Nuclear Information System (INIS)

    In 113 of 422 patients with metastatic/recurrent breast cancer (MBC who were treated in our hospital after 2001, brain/meningeal metastasis was detected. In 240 patients who died, the overall incidence of brain/meningeal metastasis was 36.3% (n=87). With respect to hormone receptor (HR) and HER2 presence, metastasis was detected in 32 (58.2%) of 55 patients showing HR(-) and HER2(+), 17 (39.5%) of 43 patients showing HR(-) and HER2(-), 19 (31.5%) of 54 patients showing HR(+) and HER2(+), and 17 (20%) of 85 patients showing HR(+) and HER2(-) (brain metastasis was detected in 2 of 3 patients in whom HR or HER2 was unclear); the incidence was significantly higher in HR(-) or HER2(+) patients. Of our series including surviving patients, asymptomatic brain metastasis was detected using contrast-enhanced MRI in 24 HER2(+) patients. In the above 113 patients, the median survival time (MST) after diagnosis was 10 months. However, it was 17 months in 24 patients who underwent screening. For treatment, whole brain radiotherapy (WBRT) or stereotactic radiosurgery (SRS) mainly with a gamma knife was performed. During a follow-up of more than 12 months, 1 to 4 sessions of treatment (mean: 2.39, median: 2) were required. In 50% of the patients, both WBRT and SRS were performed. There were no HR- or HER2- related differences in survival after brain metastasis. However, the MST was 34 months in 7 patients in whom the 1st relapse site involved the brain. In the future, the usefulness of early treatment via brain metastasis screening should be reviewed in HR(-) and HER2(+) patients. (author)

  12. Opposing Effects of Pigment Epithelium-Derived Factor on Breast Cancer Cell versus Neuronal Survival: Implication for Brain Metastasis and Metastasis-Induced Brain Damage

    OpenAIRE

    Fitzgerald, Daniel P.; Subramanian, Preeti; Deshpande, Monika; Graves, Christian; Gordon, Ira; Qian, Yongzhen; Snitkovsky, Yeva; Liewehr, David J.; Steinberg, Seth M.; Paltán-Ortiz, José D.; Herman, Mary M.; Camphausen, Kevin; Palmieri, Diane; BECERRA, S. PATRICIA; Steeg, Patricia S

    2012-01-01

    Brain metastases are a significant cause of cancer patient morbidity and mortality, yet preventative and therapeutic options remain an unmet need. The cytokine PEDF is downregulated in resected human brain metastases of breast cancer compared to primary breast tumors, suggesting that restoring its expression might limit metastatic spread. Here we show that outgrowth of large experimental brain metastases from human 231-BR or murine 4T1-BR breast cancer cells was suppressed by PEDF expression,...

  13. CHROMOSOMAL-ABERRATIONS IN FOLLICULAR THYROID-CARCINOMA - CASE-REPORT OF A PRIMARY TUMOR AND ITS METASTASIS

    NARCIS (Netherlands)

    VANDENBERG, E; VANDOORMAAL, JJ; OOSTERHUIS, JW; DEJONG, B; WIERSEMA, J; VOS, A; VERMEIJ, A; Dam, A.

    1991-01-01

    We present the result of a cytogenetic study of a case of follicular carcinoma of the thyroid and its metastasis. Both tumors have a low number of chromosomes. The primary tumor is characterized by a idic(22;22)(p11;p11). The skeletal metastasis has also structural abnormalities of chromosome 22.

  14. Solitary Laryngeal Metastasis from Transitional Cell Carcinoma of the Kidney: Clinical Case and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Tarek Assi

    2015-01-01

    Full Text Available The urogenital tract is a rare origin of laryngeal metastasis; transitional cell carcinoma with laryngeal metastases had never been reported previously. In this paper, we describe the clinical and pathological characteristics, evolution, and treatment of the first reported case of a laryngeal metastasis of a TCC followed by a brief review of the literature.

  15. Metastasis of Colorectal Adenocarcinoma to the Thyroid: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    C. Goatman

    2012-01-01

    Full Text Available Purpose. We present a rare case of colorectal metastasis to the thyroid five years following primary colonic resection. This case highlights the need to be cognisant of unusual sites of metastasis from colorectal neoplasms. Case Report. An 82-year-old male patient had a panproctocolectomy for synchronous colorectal tumours. Five years later he was found to have lung and thyroid metastases found incidentally on imaging for an acute presentation with small bowel obstruction. Conclusion. Metastases to the thyroid should be considered in the differential diagnosis of the thyroid lesion with any history of malignancy, particularly with increasing patient age and when renal cell carcinoma or lung, colon, or breast primaries are involved.

  16. Oral cavity metastasis of renal cell carcinoma: A case report

    OpenAIRE

    Will Thomas; Agarwal Neena; Petruzzelli Guy

    2008-01-01

    Abstract Introduction Despite being reported rarely, renal cell carcinoma is the third most frequent neoplasm to metastasize to the head and neck region preceded only by breast and lung cancer. Little information exists regarding the presentation and work-up of metastatic renal cell carcinoma in the oral cavity. Case presentation We report the case of a 63-year-old Caucasian man presenting with an oral cavity lesion that was painful and that had grown substantially over several months. Biopsy...

  17. Capecitabine-related intracranial hypotension syndrome mimicking dural metastasis in a breast cancer patient: Case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Cosar-Alas Rusen

    2010-01-01

    Full Text Available Spontaneous intracranial hypotension (SICH is an entity, which is secondary to iatrogenic manipulation and breaching of dura. Postural headache in patients should be suspected, cranial magnetic resonance imaging (MRI is essential for precise diagnosis. Hallmark of MRI is regular shape of pachymeningeal gadolinium enhancement and subdural effusion. It may mimic central nervous system (CNS metastasis. Prevention of such cases from receiving cranial radiotherapy by misinterpretation of the gadolinium enhancement as CNS metastasis is an important issue. Capecitabine is an antineoplastic agent, of which metabolites can cross blood-brain barrier in CNS via epithelial tissue. It may cause decrease in CSF production. SICH might be the clinical reflection of this decrease in CSF production. Review of the English literature revealed limited data because of the very little experience with oncologic patients suffering from intracranial hypotension. We report a case of spontaneous intracranial hypotension during capecitabine treatment. Patient was completely well following drug discontinuation and supportive treatment.

  18. Solitary skull metastasis as the first symptom of hepatocellular carcinoma: case report and literature review

    Directory of Open Access Journals (Sweden)

    Guo X

    2014-04-01

    Full Text Available Xieli Guo,1,2 Jiangliu Yin,3 Yugang Jiang11Department of Neurosurgery, Second Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China; 2Department of Neurosurgery, Jinjiang Hospital of Quanzhou Medical College, Jinjiang, Fujian, People's Republic of China; 3Department of Neurosurgery, Changsha Central Hospital, Changsha, Hunan, People's Republic of ChinaAbstract: Skull metastasis from hepatocellular carcinoma (HCC is reported rarely. In addition, solitary skull metastasis as the first symptom of HCC is reported even less. Here, we reported a case of solitary skull metastasis as the first symptom of HCC and reviewed the literature on skull metastasis. A 49-year-old male patient was admitted to Jinjiang Hospital of Quanzhou Medical College with a painless parietal-occipital scalp mass, and he denied any history of hepatic disease. A cranial computed tomography demonstrated a hypervascular enhancement with osteolytic change in the right parietal-occipital region, cranial magnetic resonance imaging indicated a highly enhanced and osteolytic skull tumor, and abdominal computed tomography showed a huge tumor in the liver. The other examinations showed no other metastases. Laboratory data showed no liver dysfunction while hepatitis B surface antigen was positive, and alpha fetal protein level was high. A craniectomy was performed and the mass was totally removed. The histological diagnosis was skull metastasis from HCC. The patient was subsequently treated by transcatheter arterial chemoembolization. In a review of published literature, the incidence of skull metastasis from HCC in the period between 1990 and 2011 has significantly increased. The misdiagnosis rate of skull metastases as the first symptom from HCC was high. Therefore, it is necessary to give each patient with a scalp mass that has invaded the skull a liver ultrasound or computed tomography scan. On the other hand, we found that metastases that occurred

  19. Skull Metastasis as Initial Manifestation of Pulmonary Epithelial-Myoepithelial Carcinoma: A Case Report of an Unusual Case

    Directory of Open Access Journals (Sweden)

    Masamitsu Nishihara

    2011-01-01

    Full Text Available Epithelial-myoepithelial carcinoma (EMC of the lung is rare and is considered to be low-grade malignancy. Intracranial metastasis of pulmonary EMC has not previously been reported according to our search of the literature. We report a case of skull metastasis as the initial manifestation of pulmonary EMC. An 81-year-old man complained of left leg motor weakness. Neurological examination showed left hemiparesis. Computed tomography and magnetic resonance imaging revealed an osteolytic tumor in the right frontal bone with invasion to the dura and subdural space, attached to the superior sagittal sinus. Subtotal removal of the tumor was performed, and the left hemiparesis showed improvement. Histopathological study revealed the tumor to consist of epithelial and myoepithelial cells. Pulmonary EMC was diagnosed. The MIB-1 index in primary lesion was approximately 10%. The skull and dura are possible sites for metastasis from pulmonary EMC. The MIB-1 index is a predictive marker of malignant potential.

  20. Optical pathology of human brain metastasis of lung cancer using combined resonance Raman and spatial frequency spectroscopies

    Science.gov (United States)

    Zhou, Yan; Liu, Cheng-hui; Pu, Yang; Cheng, Gangge; Zhou, Lixin; Chen, Jun; Zhu, Ke; Alfano, Robert R.

    2016-03-01

    Raman spectroscopy has become widely used for diagnostic purpose of breast, lung and brain cancers. This report introduced a new approach based on spatial frequency spectra analysis of the underlying tissue structure at different stages of brain tumor. Combined spatial frequency spectroscopy (SFS), Resonance Raman (RR) spectroscopic method is used to discriminate human brain metastasis of lung cancer from normal tissues for the first time. A total number of thirty-one label-free micrographic images of normal and metastatic brain cancer tissues obtained from a confocal micro- Raman spectroscopic system synchronously with examined RR spectra of the corresponding samples were collected from the identical site of tissue. The difference of the randomness of tissue structures between the micrograph images of metastatic brain tumor tissues and normal tissues can be recognized by analyzing spatial frequency. By fitting the distribution of the spatial frequency spectra of human brain tissues as a Gaussian function, the standard deviation, σ, can be obtained, which was used to generate a criterion to differentiate human brain cancerous tissues from the normal ones using Support Vector Machine (SVM) classifier. This SFS-SVM analysis on micrograph images presents good results with sensitivity (85%), specificity (75%) in comparison with gold standard reports of pathology and immunology. The dual-modal advantages of SFS combined with RR spectroscopy method may open a new way in the neuropathology applications.

  1. [Solitary Bladder Metastasis of Chromophobe Renal Cell Carcinoma: Report of a Case].

    Science.gov (United States)

    Nitta, Satoshi; Suetomi, Takahiro; Kojou, Kousuke; Tanaka, Ken; Kurobe, Masahiro; Yoshino, Takayuki; Yamazaki, Kazumitu; Kimura, Tomokazu; Kandori, Shuya; Kawahara, Takashi; Kawai, Kouji; Miyazaki, Jun; Yano, Youko; Yamada, Kenji; Noguchi, Masayuki; Nishiyama, Hiroyuki

    2016-02-01

    Bladder metastasis of renal cell carcinoma (RCC) is relatively rare, and only 43 cases have been reported in the Japanese literature. In most cases, the histology of the primary site was clear cell type. Here, we report a case of bladder metastasis of chromophobe RCC. A 74-year-old man presented with asymptomatic gross hematuria. He had a history of chromophobe RCC treated with radical nephrectomy 11 years previously. Since cystoscopy revealed a papillary pedunculated tumor, he underwent transurethral resection of the bladder tumor (TUR-Bt). The pathological diagnosis was chromophobe RCC because the histological findings were similar to those of nephrectomized specimens. Four years after TUR-Bt, the patient received bacillus Calmette-Guérin (BCG) therapy under the diagnosis of carcinoma in situ of urothelial cancer of the bladder but not chromophobe RCC. There was no recurrence of chromophobe RCC within 5 years follow-up after TUR-Bt. To the best of our knowledge, there has been only one other case report of bladder metastasis of chromophobe RCC in the Japanese literature. PMID:27018407

  2. Brain metastases from colorectal cancer

    DEFF Research Database (Denmark)

    Vagn-Hansen, Chris Aksel; Rafaelsen, Søren Rafael

    2001-01-01

    Brain metastases from colorectal cancer are rare. The prognosis for patients with even a single resectable brain metastasis is poor. A case of surgically treated cerebral metastasis from a rectal carcinoma is reported. The brain tumour was radically resected. However, cerebral, as well...... as extracerebral, disease recurred 12 months after diagnosis. Surgical removal of colorectal metastatic brain lesions in selected cases results in a longer survival time....

  3. Gingival Metastasis: A Case Report and Literature Review

    OpenAIRE

    Nuyen, Brian A; Tang, Christopher G

    2016-01-01

    Secondary oral cavity neoplasms are rare. We describe a case of an indurated, nonulcerating gingival lesion in a 59-year-old nonsmoking man with no family history of lung cancer. The lesion was the presenting symptom of metastatic lung adenocarcinoma. Reviewing the literature, we find that primary lung cancer among men is one of the most common cancers to metastasize to the oral cavity. Renal and cutaneous neoplasms are the next most common neoplasms to metastasize to the oral cavity. Further...

  4. Hepatic metastasis from choriocarcinoma: angiographic findings in two cases

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Yun Jung; Oh, Joo Hyeong; Yoon, Yup; Kim, Eui Jong; Kim, Deog Yoon; Kang, Heung Sun [Kyunghee University College of Medicine, Seoul (Korea, Republic of)

    2002-12-01

    We report two cases of hepatic metastases from choriocarcinoma in women of childbearing age in whom imaging studies performed at presentation revealed the presence of liver masses, and who had clinically progressive anemia or intraabdominal hemorrhage. CT demonstrated heterogeneously enhanced liver masses. Characteristic angiographic findings included hypervascular hepatic masses with aneurysmal dilatations of the peripheral hepatic arteries at the arterial phase and persistent vascular lakes at the venous phase.

  5. Breast Metastasis from Renal Cell Carcinoma: A Case Report

    International Nuclear Information System (INIS)

    Metastatic breast cancer from renal cell carcinoma is extremely rare and has non-specific findings that include a well circumscribed lesion without calcification on mammography and a well circumscribed hypoechoic lesion without posterior acoustic shadowing on sonography. We report a case of metastatic breast cancer from renal cell carcinoma and describe the radiologic findings in a 63-year-old woman who has no history of primary neoplasm

  6. Breast Metastasis from Renal Cell Carcinoma: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seon Jeong; Kim, Ji Young; Jeong, Myeong Ja; Kim, Jae Hyung; Kim, Soung Hee; Kim, Soo Hyun; Jun, Woo Sun; Kim, Hyun Jung; Han, Se Hwan [Sanggye Paik Hospital, Seoul (Korea, Republic of)

    2010-01-15

    Metastatic breast cancer from renal cell carcinoma is extremely rare and has non-specific findings that include a well circumscribed lesion without calcification on mammography and a well circumscribed hypoechoic lesion without posterior acoustic shadowing on sonography. We report a case of metastatic breast cancer from renal cell carcinoma and describe the radiologic findings in a 63-year-old woman who has no history of primary neoplasm.

  7. Unusual Presentation of Renal Cell Carcinoma: Gluteal Metastasis

    OpenAIRE

    Yunus Emre Goger; Mehmet Mesut Piskin; Mehmet Balasar; Mehmet Kilinc

    2013-01-01

    Renal cell carcinoma (RCC) has widespread and unpredictable metastatic potential. The most common sites of metastatic RCC are the lungs, lymph nodes, bones, liver, and brain; however the soft tissue metastasis is rare (2,3). Here we report a 76-year-old male patient who had renal cell carcinoma presented with gluteal metastasis. To our knowledge this is the first renal cell cancer case with gluteal metastasis at the initial diagnosis.

  8. US and MRI Findings of Penile Metastasis from Rectal Adenocarcinoma: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Ha Yeun [Kangwon National University Hospital, Chuncheon (Korea, Republic of)

    2012-03-15

    Metastatic tumors of the penis originating from the gastrointestinal tract are rare clinical conditions. We experienced a case of penile metastasis in a 59-year-old man who underwent an abdomino-peritoneal resection for a moderately-differentiated adenocarcinoma of the rectum 4 years earlier. We report penile ultrasonography and magnetic resonance imaging findings on this uncommon metastatic penile tumor from a rectal adenocarcinoma and briefly review radiologic findings and relevant literature

  9. Endobronchial metastasis of follicular thyroid carcinoma presenting as hemoptysis: A case report

    Directory of Open Access Journals (Sweden)

    Kushwaha RAS

    2008-01-01

    Full Text Available Endobronchial metastasis secondary to follicular thyroid carcinoma is extremely rare. Here, we report a case of follicular thyroid cancer in 58-year-old male who presented with hemoptysis. Computed tomography of the chest revealed multiple lung metastases. Flexible fiberoptic bronchoscopy revealed a fragile polypoid mass 5 cm distal to the vocal cords; biopsy taken from this mass revealed follicular thyroid carcinoma.

  10. [Report of a case of penile metastasis. Review of the literature].

    Science.gov (United States)

    Cuvillier, X; Donnaint, A; Rigot, J M; Mazeman, E

    1995-12-01

    Penile metastases are rare. They occur an average of 2 years after diagnosis of the primary tumour and are frequently associated with disseminated metastases. Treatment is more often palliative than curative, allowing a survival of 2 years. The authors report a case of penile metastasis secondary to a rectal cancer, discovered 29 months after treatment of the primary site. Survival with chemotherapy was 15 months. PMID:8777396

  11. Ophthalmomyiasis externa by Musca domestica in a case of orbital metastasis

    OpenAIRE

    Rose Mary Tomy; Padma B Prabhu

    2013-01-01

    Infestation of the living tissues of the eye, ocular adnexae or orbit by larvae of flies of the order Diptera is known as ophthalmomyiasis. Ophthalmomyiasis externa is a limited superficial infestation of external ocular structures such as conjunctiva and adnexae. A case of follicular carcinoma thyroid with orbital metastasis presenting as ophthalmomyiasis externa is reported. The patient presented with foul smelling ulcers of the medial and lateral orbital walls of the right eye extending in...

  12. Spontaneous regression of bone metastasis from renal cell carcinoma; A case report

    International Nuclear Information System (INIS)

    Spontaneous regression of metastatic renal cell carcinoma is rarely observed. Metastatic renal cell carcinoma was identified in a 70-year-old male using computed tomography-guided percutaneous needle biopsy. Two months after the diagnosis, a partial resection of the sternal bone was performed. Pathological examination revealed granulated tissue with bleeding and necrosis but no carcinogenic cells. We report a pathologically identified case in which a sternal bone metastasis that was noticed two years after radical nephrectomy regressed completely and spontaneously

  13. Nosocomial infection in patients with brain metastasis%脑转移瘤患者医院感染分析

    Institute of Scientific and Technical Information of China (English)

    丁维军; 杨伟芳; 于长辉

    2012-01-01

    目的 探讨脑转移瘤患者医院感染的相关因素.方法 回顾性分析510例脑转移瘤患者医院感染的临床资料.结果 78例患者并发医院感染,感染率为15.3%;其中呼吸道感染53例,占67.9%.结论 脑转移瘤患者年龄大、血糖增高、留置导尿易导致医院感染,必须加强医院感染的管理,积极控制血糖,减少留置导尿,规范抗菌药物的应用,减少医院感染的发生.%OBJECTIVE To analyze the clinical features of nosocomial infection in patients with brain metastasis. METHODS The clinical data of 510 brain metastasis tumor patients were retrospectively analyzed. RESULTS Nosocomial infection occurred in 78 patients with the infection rate of 15. 3%. The respiratory infection was the major infection which accounting for 67. 9%. CONCLUSION The incidence of nosocomial infection in brain metastasis patients is high. The elder age, hyperglycemia, and indwelling catheterization are important risk factors for nosocomial infection. To reduce the occurrence of nosocomial infection, the following strategies need to be strengthened including treating hyperglycemia with standard care, reducing indwelling caterterization and rationally using the antibiotics.

  14. An unusual case of metastasis to the left side of the heart: a case report

    Directory of Open Access Journals (Sweden)

    Boyars Michael

    2011-01-01

    Full Text Available Abstract Introduction Cardiac metastases are found in six to 20% of autopsies of patients with malignant neoplasm. The most common neoplasms that metastasize to the heart are malignant melanoma, lymphoma, and leukemia, but the relative numbers are greater with breast and lung cancers, reflecting the most common incidence of these cancers. Case presentation A 60-year-old Hispanic man presented to our hospital after being transferred from an outside hospital for workup and evaluation of an adrenal mass of the abdomen and pelvis, found on computed tomography. His chief complaint upon admission was altered mental status. Physical examination was unremarkable. He was alert and oriented and had a dry and non-erythematous oropharynx, and bilateral diffuse wheezing on lung examination. Computed tomography of the chest showed multiple hypodense lesions in the left ventricular myocardium, suggestive of metastases. There were also tiny sub-centimeter nodular densities in the right upper and lower lobes. Adrenal glands contained hypodense lesions, which showed characteristic adenocarcinomatous malignant cells. Conclusion Cancers which have metastasized to the heart are found in six to 20% of patients with malignant neoplasms. The right side of the heart is more commonly involved in metastasis. This study is unusual in that a tumor of an unknown primary origin had metastasized to the left side of the heart.

  15. Solitary renal metastasis of esophageal squamous cell carcinoma mimicking primary renal neoplasm – A case report and literature review

    OpenAIRE

    Chang, Kai-Po; Huang, Chi-Ping; Chang, Han

    2016-01-01

    Solitary renal metastasis of esophageal cancer is rare clinically, with only 14 cases being reported in the literature. The authors here report a case of a 53-year-old man with a metachronous hypopharyngeal and esophageal squamous cell carcinoma who developed a solitary renal metastasis after complete chemoradiotherapy for esophageal cancer, and subsequently received a left nephrectomy. The metastatic esophageal cancer was indistinguishable from primary renal neoplasm in the computed tomograp...

  16. Risk factors for the evaluation of potential central nervous system metastasis in Burkitt's lymphoma: a case study and literature review.

    Science.gov (United States)

    Tang, Yue-Ting; Jiao, Xiao-Yang; Chang, Xiao-Lan; Huang, Dong-Yang

    2016-03-01

    Burkitt's lymphoma (BL) is a malignancy of B lymphocytes. The rapid growth rate and frequent systemic spread result in most patients presenting with advanced disease at diagnosis. Cerebrospinal fluid cytology is the gold standard (with very high accuracy) for diagnosing BL central nervous system (CNS) metastasis; however, the low sensitivity of this method limits its clinical applications. Here, we report a case of BL with CNS metastasis. The levels of vascular endothelial growth factor (VEGF)-A and VEGF-C in the serum and cerebrospinal fluid were used to evaluate the status of BL remission and recurrence. Comparisons were made between VEGF and the other risk factors used in evaluating CNS metastasis. Although not in strict accordance, VEGF levels mirrored the disease course. Therefore, VEGF may reflect the status of BL CNS metastasis. Understanding the role of VEGF in CNS metastasis may help to improve the staging and risk classification of BL as well as the investigation of targeted therapy. PMID:25312095

  17. Cerebellum as Initial Site of Distant Metastasis from Papillary Carcinoma of Thyroid: Review of Three Cases

    Directory of Open Access Journals (Sweden)

    Mutahir A. Tunio

    2015-01-01

    Full Text Available Background. The cerebellum as initial site of distant metastasis from differentiated thyroid carcinoma (DTC including papillary (PTC and follicular thyroid carcinoma (FTC is rare manifestation. Case Presentations. Herein, we present three cases of cerebellar metastasis (CBM of PTC. Mean age of patients was 67 years (range: 64–72, and mean duration between initial diagnosis and CBM was 49.6 months (range: 37–61. Frequent location was left cerebellar hemisphere and was associated with hydrocephalus. All patients underwent suboccipital craniectomy, and in two patients postoperative intensity modulated radiation therapy (IMRT was given to deliver 5000 cGy in 25 fractions to residual lesions. Patient without postoperative IMRT had cerebellar recurrence along with lung and bone metastasis after 38 months. However, two patients were found alive and free of disease at the time of last follow-up. Conclusion. CBM from PTC is a rare clinical entity and is often associated with hydrocephalus. Histopathological diagnosis is important to initiate effective treatment, which relies on multidisciplinary approach to prolong the disease-free and overall survival rates.

  18. Excavated pulmonary nodules: an unusual clinical presentation of lung metastasis in two cases

    Directory of Open Access Journals (Sweden)

    Lalya Issam

    2010-06-01

    Full Text Available Abstract Background Excavated pulmonary metastasis are rare. We present two cases of excavated pulmonary nodules proved to be metastases from osteosarcoma and gallblader lymphoma. Case presentation The first one is 39-year-old man in whom cholecystectomy made the diagnosis of primary non-Hodgkin's lymphoma of the gallbladder. He presented in chest CT scan excavated nodules that had been biopsied and confirmed the diagnosis of non hodgkin lymphoma. He underwent 8 courses of chemotherapy CHOP 21 with complete remission. The second one is an 21 years old man who presented a right leg osteoblastic osteosarcoma with only excavated pulmonary nodules in extension assessment. He had 3 courses of polychemotherapy API (doxorubicin, platinum, and ifosfamide with partial response. Unfortunately, he died following a septic shock. Review of the literature shows that excavated pulmonary nodules as metastasis are rare but we should consider this diagnosis every time we are in front of a cancer. Chest computed tomography is the best diagnosis imaging that could make this diagnosis. Differential diagnosis between benign and malignant bullous lesions is important because surgical excision affects survival in some malignancies. Conclusions Although pulmonary nodules are the most common cancer metastasis, a differential diagnosis of a concurrent primary malignancy should always be considered every time we have excavated lesions, even in patients with known malignant disease. Thorough chest evaluation is important, as multiple primary malignancies may occur concomitantly.

  19. Solitary pancreas metastasis from AFP-producing gastric cancer: report of a case.

    Science.gov (United States)

    Natsume, Toshiyuki; Watanabe, Yoshiji; Maruyama, Takashi; Tanaka, Hajime; Shimizu, Takanori; Saito, Tsuyoshi; Kobayashi, Yutaka; Tohnosu, Noriyuki; Uehara, Toshitaka; Shimizu, Shin-ichiro; Ochiai, Takenori

    2005-01-01

    We herein present a case of resected pancreatic metachronous metastasis arising from alpha-fetoprotein-producing gastric cancer. A 75-year-old man underwent distal gastrectomy for alpha-fetoprotein-producing gastric cancer in November 1999. The staging group of TNM classification was Stage IIIA. The serum AFP level normalized after surgical resection. During the follow-up period, it increased to 42ng/mL in January 2002, and up to 550ng/mL in July 2002: Abdominal computed tomography disclosed a 4-cm mass in the tail of the pancreas and under the diagnosis of pancreas metastasis, distal pancreatectomy with splenectomy was performed. Following this, serum alpha-fetoprotein declined to 61ng/mL, and the postoperative course was uneventful. But it elevated again to 200ng/mL in August, and to 3500ng/mL in September 2002. Computed tomography revealed multiple liver metastases. He was treated with TS-1, but hepatic lesions continued to grow and he died in March 2003. To our knowledge, this case is the first report of resection of solitary pancreas metastasis of alpha-fetoprotein-producing gastric cancer. PMID:16001678

  20. Bilateral synchronous breast carcinomas followed by a metastasis to the gallbladder: a case report

    Directory of Open Access Journals (Sweden)

    Dardamanis Dimitrios

    2007-09-01

    Full Text Available Abstract Background Breast cancer is usually associated with metastases to lungs, bones and liver. Breast carcinoma metastasizing to the gallbladder is very rare. Case presentation A 59-year-old woman presented with bilateral synchronous breast lesions. A palpable, retroareolar solid lesion of diameter equal to 5 cm was present in the right breast, and a newly developed, non-palpable lesion with microcalcifications (diameter equal to 0.7 cm was present in the upper outer quadrant of the left breast. Modified radical mastectomy was performed on the right breast and lumpectomy after hook-wire localization was performed on the left breast, combined with lymph node dissection in both sides. The pathological examination revealed invasive lobular carcinoma grade II in the right breast and invasive ductal carcinoma grade I in the left breast. Chemotherapy, radiation therapy, trastuzumab and letrozole were appropriately administered. At her 18-month follow-up, the patient was free of symptoms; the imaging tests (chest CT, abdominal U/S, bone scan, biochemical tests, blood cell count and tumor markers were also normal. At the 20th month after surgery however, the patient developed symptoms of cholecystitis and underwent cholecystectomy. The histopathological examination revealed metastasis of the lobular carcinoma to the gallbladder. Conclusion This extremely rare case confirms on a single patient the results of large series having demonstrated the preferential metastasis of lobular breast cancer to the gallbladder. Symptoms of cholecystitis should not be neglected in such patients, as they might indicate metastasis to the gallbladder.

  1. Solitary necrotic nodules of the liver mimicking hepatic metastasis: report of two cases

    International Nuclear Information System (INIS)

    We present two cases of solitary necrotic nodules of the liver which on radiologic images mimicked hepatic metastasis. Solitary necrotic nodule of the liver is a rare but benign entity which histopathologically consists of an outer fibrotic capsule with inflammatory cells and a central core of amorphous necrotic material. The lesion was seen on contrast-enhanced CT as an ovoid-shaped hypoattenuating nodule; on CT during hepatic arteriography as enhancing nodule; on intraoperative US as a target-appearing hypoechoic nodule; on T2WI as a hyperintensity nodule, and on dynamic MR as a subtle peripheral enhancing nodule. Although the radiologic features are not specific, solitary necrotic nodule of the liver should be included in the differential diagnosis of hepatic metastasis

  2. A Rare Case of Calf Muscle Metastasis from a Non-Functional Pancreatic Neuroendocrine Carcinoma

    International Nuclear Information System (INIS)

    Pancreatic neuroendocrine tumors (PNET) are uncommon pancreatic neoplasms, accounting for 1-2% of all pancreatic tumors. However, they have a better prognosis and long-term survival compared to exocrine pancreatic cancer. PNETs can be divided into functional or non-functional based upon whether or not they excrete active substances relevant to specific clinical syndromes. Skeletal muscle metastasis is also a rare condition and differentiation between a primary soft tissue sarcoma and metastatic carcinoma is difficult without biopsy. Thus, skeletal muscle metastases from pancreatic neoplasms are exceedingly rare, with only a few cases reported in the literature. We present a 34-year-old man with metastatic pancreatic neuroendocrine carcinoma that was initially thought to be a primary soft tissue tumor. Pathology and immunohistochemistry demonstrated the tumor to be a metastasis from a pancreatic neuroendocrine carcinoma. A brief review of the literature on this subject is also presented

  3. Surgical resection of a solitary liver metastasis from nasopharyngeal carcinoma:a case report

    Institute of Scientific and Technical Information of China (English)

    Spiros Delis; Ioannis Biliatis; Antonia Bourli; Nikolaos Kapranos; Christos Dervenis

    2006-01-01

    BACKGROUND: Nasopharyngeal carcinoma (NPC) has a propensity to develop distant metastases at a high rate and with poor prognosis. Metastatic sites are usually multifocal and involve bones, lungs, liver and distant lymph nodes. Management of metastatic disease is essentially palliative and is based on chemotherapy. METHODS:A 50-year-old man with a solitary liver metastasis from a newly diagnosed NPC was treated by segmentectomy. Prior to surgery, neoadjuvant chemo-therapy followed by concurrent chemoradiotherapy was administered. RESULTS:Complete remission of the primary disease was achieved, although the size of the hepatic lesion was increased. After resection of the liver metastasis, no signs of local or distant recurrence was noted during the 6-month follow up. CONCLUSION:Although surgical treatment has a limited role in metastatic NPC, there are rare cases of localized disease with a reasonable outcome after resection.

  4. Whole brain radiotherapy with a conformational external beam radiation boost for lung cancer patients with 1-3 brain metastasis: a multi institutional study

    International Nuclear Information System (INIS)

    To determine the outcome of patients with brain metastasis (BM) from lung cancer treated with an external beam radiotherapy boost (RTB) after whole brain radiotherapy (WBRT). A total of 53 BM patients with lung cancer were treated sequentially with WBRT and RTB between 1996 and 2008 according to our institutional protocol. Mean age was 58.8 years. The median KPS was 90. Median recursive partitioning analysis (RPA) and graded prognostic assessment (GPA) grouping were 2 and 2.5, respectively. Surgery was performed on 38 (71%) patients. The median number of BM was 1 (range, 1-3). Median WBRT and RTB combined dose was 39 Gy (range, 37.5 - 54). Median follow-up was 12.0 months. During the period of follow-up, 37 (70%) patients died. The median overall survival (OS) was 14.5 months. Only 13 patients failed in the brain. The majority of patients (n = 29) failed distantly. The 1-year OS, -local control, extracranial failure rates were 61.2%, 75.2% and 60.8%, respectively. On univariate analysis, improved OS was found to be significantly associated with total dose (≤ 39 Gy vs. > 39 Gy; p < 0.01), age < 65 (p < 0.01), absence of extracranial metastasis (p < 0.01), GPA ≥ 2.5 (p = 0.01), KPS ≥ 90 (p = 0.01), and RPA < 2 (p = 0.04). On multivariate analysis, total dose (p < 0.01) and the absence of extracranial metastasis (p = 0.03) retained statistical significance. The majority of lung cancer patients treated with WBRT and RTB progressed extracranially. There might be a subgroup of younger patients with good performance status and no extracranial disease who may benefit from dose escalation after WBRT to the metastatic site

  5. Secondary Metastasis to the Mandible From Breast Carcinoma -A Rare Case Report.

    Science.gov (United States)

    Thorawat, Amit; Naikmasur, Venkatesh G; Patil, Preeti; Perumal, Priya

    2015-07-01

    Regardless of the rare occurrence of metastatic lesions to the jaw, it should be taken into consideration in the individuals with a history of malignancy. Early detection requires accurate examination, and microscopic evaluation is essential. In this paper we report a case of breast carcinoma to the mandible as female breast cancer is the most frequent metastatic lesion to the mandible and its metastasis is well documented. The patient's medical history revealed that she had undergone mastectomy on the left breast three years ago. As this condition is infrequently described, documentation of new cases will augment the existing knowledge. PMID:26393225

  6. Combined surgical and radiosurgical treatment for a symptomatic cervical metastasis in a case of malignant paraganglioma: a case report

    OpenAIRE

    Sasaki, Ken; Inose, Hiroyuki; Kawabata, Shigenori; Yoshii, Toshitaka; Kato, Tsuyoshi; Saito, Masanori; Okawa, Atsushi

    2013-01-01

    Background Paragangliomas of the head and neck are rare tumors. Moreover, malignant paragangliomas of the cervical spine are extremely rare. Currently, the combination of curative surgical resection and secondary adjuvant radiotherapy is the gold standard for treating symptomatic malignant paragangliomas. However, traditional treatments for malignant paraganglioma remain unsuccessful. The purpose of this study is to report an exceedingly rare case involving cervical metastasis of a malignant ...

  7. Breast metastasis from lung cancer:a report of two cases and literature review

    Institute of Scientific and Technical Information of China (English)

    Li Wang; Shu-Ling Wang; Hong-Hong Shen; Feng-Ting Niu; Yun Niu

    2014-01-01

    Breast metastasis from extra-mammary malignancy is rare. An incidence of 0.4% to 1.3% has been reported in literature. hTe primary malignancies that most commonly metastasize to the breast are leukemia, lymphoma, and malignant melanoma. In this report, two cases of pulmonary metastasis to the breast were presented. A 40-year-old female manifested a right breast mass of 2-month duration. Atfer physical examination was performed, a poorly deifned mass was noted in the upper outer quadrant of the right breast. Another 49-year-old female manifested right breast mass of 5-day duration. A poorly deifned mass was noted in the lower inner quadrant of the right breast. Mammography results also revealed breast cancer. hTe patients underwent local excision. Atfer histological and immunohistochemical analyses were conducted, a primary lung carcinoma that metastasized to the breast was diagnosed. An accurate differentiation of metastasis to the breast from primary breast cancer is very important because the treatment and prognosis of the two differ signiifcantly.

  8. STAT3 pathway regulates lung-derived brain metastasis initiating cell capacity through miR-21 activation.

    Science.gov (United States)

    Singh, Mohini; Garg, Neha; Venugopal, Chitra; Hallett, Robin; Tokar, Tomas; McFarlane, Nicole; Mahendram, Sujeivan; Bakhshinyan, David; Manoranjan, Branavan; Vora, Parvez; Qazi, Maleeha; Arpin, Carolynn C; Page, Brent; Haftchenary, Sina; Rosa, David A; Lai, Ping-Shan; Gómez-Biagi, Rodolfo F; Ali, Ahmed M; Lewis, Andrew; Geletu, Mulu; Murty, Naresh K; Hassell, John A; Jurisica, Igor; Gunning, Patrick T; Singh, Sheila K

    2015-09-29

    Brain metastases (BM) represent the most common tumor to affect the adult central nervous system. Despite the increasing incidence of BM, likely due to consistently improving treatment of primary cancers, BM remain severely understudied. In this study, we utilized patient-derived stem cell lines from lung-to-brain metastases to examine the regulatory role of STAT3 in brain metastasis initiating cells (BMICs). Annotation of our previously described BMIC regulatory genes with protein-protein interaction network mapping identified STAT3 as a novel protein interactor. STAT3 knockdown showed a reduction in BMIC self-renewal and migration, and decreased tumor size in vivo. Screening of BMIC lines with a library of STAT3 inhibitors identified one inhibitor to significantly reduce tumor formation. Meta-analysis identified the oncomir microRNA-21 (miR-21) as a target of STAT3 activity. Inhibition of miR-21 displayed similar reductions in BMIC self-renewal and migration as STAT3 knockdown. Knockdown of STAT3 also reduced expression of known downstream targets of miR-21. Our studies have thus identified STAT3 and miR-21 as cooperative regulators of stemness, migration and tumor initiation in lung-derived BM. Therefore, STAT3 represents a potential therapeutic target in the treatment of lung-to-brain metastases. PMID:26314961

  9. A Case Report of Brain Stem Tumor

    Directory of Open Access Journals (Sweden)

    R Nazari

    2004-07-01

    Full Text Available Background: Brain and spinal cord tumors are the most frequent neoplasms after leukemia in children. Brain stem glioma is responsible for 10-20% of brain tumors in this group and often found in pons presenting with cerebellar signs, cranial nerve palsies, pyramidal signs and eventually increased intracranial pressure Case Report: In this article we reported an 11 year old girl affected with brain stem tumor with signs of headache, dizziness, vomiting and ataxia. Strabismus due to palsy of sixth cranial nerve, and dysarthria was observed. Conclusion: Children complaining of vomiting, headache and dizziness for a long time must be assessed for brain tumor in posterior fossa that sometimes may lead to increased intracranial pressure. An exact neurological examination can be worth guide to diagnosis.

  10. In Vitro Treatment of Melanoma Brain Metastasis by Simultaneously Targeting the MAPK and PI3K Signaling Pathways

    Directory of Open Access Journals (Sweden)

    Inderjit Daphu

    2014-05-01

    Full Text Available Malignant melanoma is the most lethal form of skin cancer, with a high propensity to metastasize to the brain. More than 60% of melanomas have the BRAFV600E mutation, which activates the mitogen-activated protein kinase (MAPK pathway [1]. In addition, increased PI3K (phosphoinositide 3-kinase pathway activity has been demonstrated, through the loss of activity of the tumor suppressor gene, PTEN [2]. Here, we treated two melanoma brain metastasis cell lines, H1_DL2, harboring a BRAFV600E mutation and PTEN loss, and H3, harboring WT (wild-type BRAF and PTEN loss, with the MAPK (BRAF inhibitor vemurafenib and the PI3K pathway associated mTOR inhibitor temsirolimus. Combined use of the drugs inhibited tumor cell growth and proliferation in vitro in H1_DL2 cells, compared to single drug treatment. Treatment was less effective in the H3 cells. Furthermore, a strong inhibitory effect on the viability of H1_DL2 cells, when grown as 3D multicellular spheroids, was seen. The treatment inhibited the expression of pERK1/2 and reduced the expression of pAKT and p-mTOR in H1_DL2 cells, confirming that the MAPK and PI3K pathways were inhibited after drug treatment. Microarray experiments followed by principal component analysis (PCA mapping showed distinct gene clustering after treatment, and cell cycle checkpoint regulators were affected. Global gene analysis indicated that functions related to cell survival and invasion were influenced by combined treatment. In conclusion, we demonstrate for the first time that combined therapy with vemurafenib and temsirolimus is effective on melanoma brain metastasis cells in vitro. The presented results highlight the potential of combined treatment to overcome treatment resistance that may develop after vemurafenib treatment of melanomas.

  11. Long-term survival in patients with non-small cell lung cancer and synchronous brain metastasis treated with whole-brain radiotherapy and thoracic chemoradiation

    International Nuclear Information System (INIS)

    Brain metastases occur in 30-50% of Non-small cell lung cancer (NSCLC) patients and confer a worse prognosis and quality of life. These patients are usually treated with Whole-brain radiotherapy (WBRT) followed by systemic therapy. Few studies have evaluated the role of chemoradiotherapy to the primary tumor after WBRT as definitive treatment in the management of these patients. We reviewed the outcome of 30 patients with primary NSCLC and brain metastasis at diagnosis without evidence of other metastatic sites. Patients were treated with WBRT and after induction chemotherapy with paclitaxel and cisplatin for two cycles. In the absence of progression, concurrent chemoradiotherapy for the primary tumor with weekly paclitaxel and carboplatin was indicated, with a total effective dose of 60 Gy. If disease progression was ruled out, four chemotherapy cycles followed. Median Progression-free survival (PFS) and Overall survival (OS) were 8.43 ± 1.5 and 31.8 ± 15.8 months, respectively. PFS was 39.5% at 1 year and 24.7% at 2 years. The 1- and 2-year OS rates were 71.1 and 60.2%, respectively. Three-year OS was significantly superior for patients with N0-N1 stage disease vs. N2-N3 (60 vs. 24%, respectively; Response rate [RR], 0.03; p= 0.038). Patients with NSCLC and brain metastasis might benefit from treatment with WBRT and concurrent thoracic chemoradiotherapy. The subgroup of N0-N1 patients appears to achieve the greatest benefit. The result of this study warrants a prospective trial to confirm the benefit of this treatment

  12. A RARE CASE OF MAXILLARY SINUS METASTASIS OF RENAL CELL CARCINOMA

    Directory of Open Access Journals (Sweden)

    E. N. Novozhilova

    2015-04-01

    Full Text Available The paper describes a rare case of maxillary sinus metastasis of renal cell carcinoma in a 50-year-old man 7 years after nephrectomy. The tumor appeared as bleeding leading to anemia. The diagnostic difficulties associated with differences in X-ray and biopsy morphological data are considered. A correct diagnosis could be established during planned histological examination of the removed tumor. Adjuvant immunotherapy was performed. Examination following 8 postoperative months revealed no signs of progressive disease. The authors give a literature review.

  13. Mesothelial Cyst of the Round Ligament Mimicking a Metastasis: a Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bo Mi; Lee, Ji Young; Han, Yoon Hee; Kim, Su Young; Seo, Jung Wook; Kim, Yong Hoon; Cha, Soon Joo; Hur, Gham; Joo, Mee; Lee, Eung Soo [Ilsan Paik Hospital, Inje University, School of Medicine, Goyang (Korea, Republic of)

    2010-06-15

    A mesothelial cyst of the round ligament is a rare cause of an inguinal mass. Clinically, it is frequently misdiagnosed as one of commoner diseases such as an inguinal hernia, femoral hernia, lipoma, and lymphadenopathy upon physical examination. Some previous reports elaborated the sonographic features of a mesothelial cyst of the round ligament. However, to our knowledge, few reports have described the CT features of a mesothelial cyst. We illustrated here the sonographic and multidetector CT features of a case of a mesothelial cyst of the round ligament that presented as an inguinal palpable mass and mimicked a metastasis in a patient with a Sertoli-Leydig cell tumor of the ovary.

  14. Consecutive acquisition of time-resolved contrast-enhanced MR angiography and perfusion MR imaging with added dose of gadolinium-based contrast agent Aids diagnosis of suspected brain metastasis

    International Nuclear Information System (INIS)

    Time-resolved contrast-enhanced magnetic resonance (MR) angiography (TCMRA) and perfusion MR imaging (PWI) have been used to assess the hemodynamics of brain tumors. We assessed the feasibility and value of consecutive performance of these techniques to evaluate suspected brain metastasis following supplementary injection of gadolinium-based contrast medium. In 69 patients with suspected brain metastasis, we obtained precontrast MR images followed by TCMRA and postcontrast T1-weighted images after administration of 0.1 mmol/kg gadoteridol. When findings were negative or equivocal, we injected an additional 0.1-mmol/kg dose of gadoteridol and obtained PWI and second postcontrast T1-weighted images. We used a 3-point scale to grade perfusion maps and TCMRA and assessed whether these techniques added information to conventional MR imaging in the differential diagnosis. We also evaluated whether the second contrast injection improved the conspicuity and/or number of enhancing lesions and used a 4-point scoring system to quantitatively analyze diagnostic yield of TCMRA and PWI. We could assess tumor hemodynamics on PWI maps and TCMRA images in all 69 patients. In 14 cases (20%), PWI and/or TCMRA added information to conventional MR findings. After second injection of contrast medium, lesion conspicuity improved in 58 of the 69 cases (84%), and the number of detected lesions increased in 11 of 31 cases diagnosed with metastatic disease (36%). Quantitative analysis revealed TCMRA and PWI provided significant additional diagnostic information (Kruskal-Wallis test, P<0.0001). Consecutive acquisition of TCMRA and PWI using supplementary contrast injection can facilitate differential diagnosis of suspected brain metastasis and improve the number and conspicuity of detected lesions. (author)

  15. Brain abscess: surgical experiences of 162 cases

    Directory of Open Access Journals (Sweden)

    Forhad Hossain Chowdhury

    2015-01-01

    Full Text Available Aim: Brain abscess still poses a public health challenge in spite of the advent of modern neurosurgical techniques and antibiotics. Here, we present our surgical experiences and ultimate outcome in the management of brain abscess. Methods: Totally, 162 patients with proved brain abscess who underwent surgical treatment were included in this study. The prospectively recorded data of surgical management of brain abscess and the ultimate outcome (by Glasgow outcome scale were studied retrospectively. Results: Total number of cases was 162, of which 113 were acute pyogenic abscess while 49 were chronic abscess. Among the chronic abscess, 29 were chronic pyogenic abscess, 14 were tubercular, 3 aspergillus, and 3 abscesses were in malignant brain metastases. In acute cases, common clinical features were headache, fever, vomiting, focal deficit and seizure. In chronic abscesses, common clinical features were mild to moderate headache and progressive focal deficit. Seventy-three (45.06% patients had adjacent localized sinus, middle ear or cranial infection. The common predisposing factors included postneurosurgery, postpenetrating injury to brain, chronic suppurative otitis media, and congenital heart disease, infective endocarditis, sinusitis and sub optimum immuno-status. Frontal lobe involved in 30.2% cases, temporal lobe is next to involved. Single time burr hole aspiration in 111 (68.5% cases, two or more times burr hole aspiration were done in 34 (21% cases. Pus culture was negative in 129 (79.62% cases. Total number of death was 22 (13.58% cases. Complete resolution of abscess with complete recovery of preoperative neuro-deficit was seen in 80.86% cases and recovery with major neuro-deficit was observed in 5.55% cases. There is a significant association between Glasgow coma scale (GCS on admission and mortality in brain abscess. Conclusion: In most of the cases, pus culture did not yield growth of any causative organism. Mortality was not

  16. Ophthalmomyiasis externa by Musca domestica in a case of orbital metastasis.

    Science.gov (United States)

    Tomy, Rose Mary; Prabhu, Padma B

    2013-11-01

    Infestation of the living tissues of the eye, ocular adnexae or orbit by larvae of flies of the order Diptera is known as ophthalmomyiasis. Ophthalmomyiasis externa is a limited superficial infestation of external ocular structures such as conjunctiva and adnexae. A case of follicular carcinoma thyroid with orbital metastasis presenting as ophthalmomyiasis externa is reported. The patient presented with foul smelling ulcers of the medial and lateral orbital walls of the right eye extending into the lids and nose, teeming with maggots. Computerized Tomography (CT) showed widespread bone destruction with extension into surrounding sinuses. Over 200 maggots were manually removed after immobilisation with turpentine oil instillation. Entomological examination showed it to be a case of accidental myiasis caused by the common housefly Musca domestica. The patient was managed conservatively and the ulcer cavities filled up with healthy granulation tissue. This case is presented on account of its rarity. PMID:24145557

  17. Ophthalmomyiasis externa by Musca domestica in a case of orbital metastasis

    Directory of Open Access Journals (Sweden)

    Rose Mary Tomy

    2013-01-01

    Full Text Available Infestation of the living tissues of the eye, ocular adnexae or orbit by larvae of flies of the order Diptera is known as ophthalmomyiasis. Ophthalmomyiasis externa is a limited superficial infestation of external ocular structures such as conjunctiva and adnexae. A case of follicular carcinoma thyroid with orbital metastasis presenting as ophthalmomyiasis externa is reported. The patient presented with foul smelling ulcers of the medial and lateral orbital walls of the right eye extending into the lids and nose, teeming with maggots. Computerized Tomography (CT showed widespread bone destruction with extension into surrounding sinuses. Over 200 maggots were manually removed after immobilisation with turpentine oil instillation. Entomological examination showed it to be a case of accidental myiasis caused by the common housefly Musca domestica. The patient was managed conservatively and the ulcer cavities filled up with healthy granulation tissue. This case is presented on account of its rarity.

  18. Relevance of PTEN loss in brain metastasis formation in breast cancer patients.

    OpenAIRE

    Wikman, Harriet; Lamszus, Katrin; Detels, Niclas; Uslar, Liubov; Wrage, Michaela; Benner, Christian; Hohensee, Ina; Ylstra, Bauke; Eylmann, Kathrin; Zapatka, Marc; Sauter, Guido; Kemming, Dirk; Glatzel, Markus; Müller, Volkmar; Westphal, Manfred

    2012-01-01

    Introduction With the improvement of therapeutic options for the treatment of breast cancer, the development of brain metastases has become a major limitation to life expectancy in many patients. Therefore, our aim was to identify molecular markers associated with the development of brain metastases in breast cancer. Methods Patterns of chromosomal aberrations in primary breast tumors and brain metastases were compared with array-comparative genetic hybridization (CGH). The most significant r...

  19. Vertebral Compression Fracture Related to Pancreatic Cancer With Osteoblastic Metastasis: A Case Report and Literature Review.

    Science.gov (United States)

    Chih, Yu-Pin; Wu, Wei-Ting; Lin, Chien-Lin; Jou, Herng-Jeng; Huang, Yu-Hsuan; Chen, Liang-Chi; Chou, Li-Wei

    2016-02-01

    Compression fracture of the vertebral body is common in the older patients. The possible etiology like osteoporosis or cancer metastasis should be included as a possibility in the differential diagnosis for severe back pain, to prevent delays in diagnosis and treatment. More severe fractures can cause significant pain, leading to inability to perform activities of daily living, and life-threatening in the older patient.We report a rare case of a 61-year-old man suffering from severe lower back pain and intermittent abdominal fullness. He came to our clinic, where muscle power was normal, but could not stand up or change posture because of severe back pain. Plain film and magnetic resonance imaging of lumbar spine both revealed osteoblastic lesion at L2 spine. Abdomen computed tomography showed a mass at the pancreatic body. The pancreatic cancer with osteoblastic metastasis was diagnosed. After receiving multimodality therapy such as percutaneous vertebroplasty and pain controlling, we provided effective palliation of symptoms, aggressive rehabilitation program, and better quality of life.Our case highlights the benefits of multidisciplinary cancer treatment for such patient, preventing the complications such as immobilization accompanied with adverse effects like musculoskeletal, respiratory, and cardiovascular systems. All clinicians should be informed of the clinical findings to provide patients with suitable therapies and surveys. PMID:26844499

  20. A Case of Lung Cancer with Brain Metastases Diagnosed After Epileptic Seizure

    Directory of Open Access Journals (Sweden)

    Murat Eroglu

    2014-03-01

    Full Text Available    Epileptic seizures can accompany benign diseases, also can be the first sign of malign tumors. In brain metastasis, epileptic seizures can be seen before the symptoms of the primary lesion. Brain metastasis is bad prognostic factor in all malignancies and it is determined that lung cancers are the most metastatic tumors to the brain. Especially in new onset epileptic seizures in elderly patients, metastatic brain tumors are frequent in etiology. We aimed to present a lung cancer patient with brain metastasis who admitted emergency department with first epileptic seizure.

  1. Discordance of Mutation Statuses of Epidermal Growth Factor Receptor and K-ras between Primary Adenocarcinoma of Lung and Brain Metastasis.

    Science.gov (United States)

    Rau, Kun-Ming; Chen, Han-Ku; Shiu, Li-Yen; Chao, Tsai-Ling; Lo, Yi-Ping; Wang, Chin-Chou; Lin, Meng-Chih; Huang, Chao-Cheng

    2016-01-01

    Mutations on epidermal growth factor receptor (EGFR) of adenocarcinomas of lung have been found to be associated with increased sensitivity to EGFR tyrosine kinase inhibitors and K-ras mutations may correlate with primary resistance. We aimed to explore the discordant mutation statuses of EGFR and K-ras between primary tumors and matched brain metastases in adenocarcinomas of lung. We used a sensitive Scorpion ARMS method to analyze EGFR mutation, and Sanger sequencing followed by allele-specific real-time polymerase chain reaction to analyze K-ras mutation. Forty-nine paired tissues with both primary adenocarcinoma of lung and matched brain metastasis were collected. Thirteen patients (26.5%) were discordant for the status of EGFR between primary and metastatic sites. K-ras gene could be checked in paired specimens from 33 patients, thirteen patients (39.6%) were discordant for the status of K-ras. In primary lung adenocarcinoma, there were 14 patients of mutant EGFR had mutant K-ras synchronously. This study revealed that the status of EGFR mutation in lung adenocarcinomas is relatively consistent between primary and metastatic sites compared to K-ras mutation. However, there are still a few cases of adenocarcinoma of lung showing discordance for the status of EGFR mutation. Repeated analysis of EGFR mutation is highly recommended if tissue from metastatic or recurrent site is available for the evaluation of target therapy. PMID:27070580

  2. Choroidal metastasis from early rectal cancer: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Mitsuyoshi Tei

    2014-01-01

    CONCLUSION: This is the first report of choroidal metastasis from early rectal cancer. We consider it important to enforce systemic chemotherapy in addition to radiotherapy for choroidal metastasis from colorectal cancer.

  3. The metastasis-promoting S100A4 protein confers neuroprotection in brain injury

    DEFF Research Database (Denmark)

    Dmytriyeva, Oksana; Pankratova, Stanislava; Owczarek, Sylwia;

    2012-01-01

    Identification of novel pro-survival factors in the brain is paramount for developing neuroprotective therapies. The multifunctional S100 family proteins have important roles in many human diseases and are also upregulated by brain injury. However, S100 functions in the nervous system remain...... unclear. Here we show that the S100A4 protein, mostly studied in cancer, is overexpressed in the damaged human and rodent brain and released from stressed astrocytes. Genetic deletion of S100A4 exacerbates neuronal loss after brain trauma or excitotoxicity, increasing oxidative cell damage and...... downregulating the neuroprotective protein metallothionein I+II. We identify two neurotrophic motifs in S100A4 and show that these motifs are neuroprotective in animal models of brain trauma. Finally, we find that S100A4 rescues neurons via the Janus kinase/STAT pathway and, partially, the interleukin-10...

  4. Clinical study of 28 cases of cervical lymph node metastasis from an unknown primary carcinoma

    International Nuclear Information System (INIS)

    From 1989 to 2005, 28 patients-20 men and 8 women-with cervical lymph node metastasis from an unknown primary carcinoma were treated and studied retrospectively. In histological diagnosis, open biopsy was conducted in 11 patients and non-open biopsy (fine needle aspiration (FNA) or frozen section diagnosis during surgery) in 17. Blind biopsy under general anesthesia was conducted in 10 patients, showing one primary tumor in the nasopharynx. Tonsillectomy for diagnosis was not done. In region of maximum-size lymph node metastasis, the upper cervical region accounted for 22 cases (79%). The N stage of cervical lymph nodes was as follows: N2a in 4, N2b in 14, N2c in 3, and N3 in 7. The histopathological diagnosis of cervical lymph node was as follows: squamous cell carcinoma in 21, adenocarcinoma in 3, mucoepidermoid carcinoma in 2, and others in 2. Therapy was as follows: only neck dissection in 7, neck dissection with postoperative radiation therapy in 13, and irradiation and chemotherapy in 8. All patients treated with irradiation and chemotherapy had been judged to be inoperable. Seven patients were found to have a subsequent primary tumor. Primary tumor sites were as follows: tonsils in 3 and upper gingiva, base of tongue, lung, and nasopharynx in 1 each. Fluorodeoxyglucose-positron emission tomography (FDG-PET) was conducted in 7 patients but revealed no primary tumor. Overall 5-year survival in this study was 46%. We should pay particular attention to the tonsils for detecting primary tumors in patients with cervical metastasis from an unknown primary carcinoma. (author)

  5. Comparison of Clinical Outcomes of Surgery Followed by Local Brain Radiotherapy and Surgery Followed by Whole Brain Radiotherapy in Patients With Single Brain Metastasis: Single-Center Retrospective Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Hashimoto, Kenji [Division of Neurosurgery, National Cancer Center Hospital, Tokyo (Japan); Narita, Yoshitaka, E-mail: yonarita@ncc.go.jp [Division of Neurosurgery, National Cancer Center Hospital, Tokyo (Japan); Miyakita, Yasuji; Ohno, Makoto [Division of Neurosurgery, National Cancer Center Hospital, Tokyo (Japan); Sumi, Minako; Mayahara, Hiroshi [Division of Radiation Oncology, National Cancer Center Hospital, Tokyo (Japan); Kayama, Takamasa; Shibui, Soichiro [Division of Neurosurgery, National Cancer Center Hospital, Tokyo (Japan)

    2011-11-15

    Purpose: Data comparing the clinical outcomes of local brain radiotherapy (LBRT) and whole brain RT (WBRT) in patients with a single brain metastasis after tumor removal are limited. Patients and Methods: A retrospective analysis was performed to compare the patterns of treatment failure, cause of death, progression-free survival, median survival time, and Karnofsky performance status for long-term survivors among patients who underwent surgery followed by either LBRT or WBRT between 1990 and 2008 at the National Cancer Center Hospital. Results: A total of 130 consecutive patients were identified. The median progression-free survival period among the patients who received postoperative LBRT (n = 64) and WBRT (n = 66) was 9.7 and 11.5 months, respectively (p = .75). The local recurrence rates (LBRT, 9.4% vs. WBRT, 12.1%) and intracranial new metastasis rate (LBRT, 42.2% vs. WBRT, 33.3%) were similar in each arm. The incidence of leptomeningeal metastasis was also equivalent (LBRT, 9.4% vs. WBRT, 10.6%). The median survival time for the LBRT and WBRT patients was 13.9 and 16.7 months, respectively (p = .88). A neurologic cause of death was noted in 35.6% of the patients in the LBRT group and 36.7% of the WBRT group (p = .99). The Karnofsky performance status at 2 years was comparable between the two groups. Conclusions: The clinical outcomes of LBRT and WBRT were similar. A prospective evaluation is warranted.

  6. Comparison of Clinical Outcomes of Surgery Followed by Local Brain Radiotherapy and Surgery Followed by Whole Brain Radiotherapy in Patients With Single Brain Metastasis: Single-Center Retrospective Analysis

    International Nuclear Information System (INIS)

    Purpose: Data comparing the clinical outcomes of local brain radiotherapy (LBRT) and whole brain RT (WBRT) in patients with a single brain metastasis after tumor removal are limited. Patients and Methods: A retrospective analysis was performed to compare the patterns of treatment failure, cause of death, progression-free survival, median survival time, and Karnofsky performance status for long-term survivors among patients who underwent surgery followed by either LBRT or WBRT between 1990 and 2008 at the National Cancer Center Hospital. Results: A total of 130 consecutive patients were identified. The median progression-free survival period among the patients who received postoperative LBRT (n = 64) and WBRT (n = 66) was 9.7 and 11.5 months, respectively (p = .75). The local recurrence rates (LBRT, 9.4% vs. WBRT, 12.1%) and intracranial new metastasis rate (LBRT, 42.2% vs. WBRT, 33.3%) were similar in each arm. The incidence of leptomeningeal metastasis was also equivalent (LBRT, 9.4% vs. WBRT, 10.6%). The median survival time for the LBRT and WBRT patients was 13.9 and 16.7 months, respectively (p = .88). A neurologic cause of death was noted in 35.6% of the patients in the LBRT group and 36.7% of the WBRT group (p = .99). The Karnofsky performance status at 2 years was comparable between the two groups. Conclusions: The clinical outcomes of LBRT and WBRT were similar. A prospective evaluation is warranted.

  7. Isolated metastasis of hepatocellular carcinoma to the gallbladder mimicking gallbladder carcinoma: A case report

    International Nuclear Information System (INIS)

    Metastasis of hepatocellular carcinoma (HCC) to the gallbladder (GB) through direct invasion is relatively common; on the other hand, isolated metastasis of HCC to the GB is extremely rare. We report here the radiologic finding of an isolated metastasis of HCC to the GB appearing as a polypoid mass in the GB lumen mimicking GB cancer in a patient treated for HCC

  8. Metachronous Colon Metastasis to the Thyroid: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Dvir Froylich

    2013-01-01

    Full Text Available The thyroid gland is a known site for metastatic tumors from various primary sites. Thyroid metastases are not an exceptional finding at autopsy, and they are encountered in 2% to 9% of the patients with malignant neoplasm. The most frequent tumors to metastasize are breast, lung, melanoma, and kidney carcinomas. Despite the fact that it is one of the largest vascular organs in the body, clinical and surgical cases have given an incidence of 3% of secondary malignances of this organ. Metastatic colon carcinoma to the thyroid gland has been reported, and it is not as rare as one might think. We present a very unique case of colon carcinoma metastasis to the right thyroid lobe and lung five years after colon resection, with reoccurrence two years later in the contralateral thyroid lobe. The literature regarding colon cancer metastasizing to the thyroid gland was reviewed with an attempt to disclose features of this presentation regarding patient’s prognosis.

  9. Mucinous carcinoma with axillary lymph node metastasis in a male breast: A case report

    Directory of Open Access Journals (Sweden)

    Faten Hammedi

    2010-01-01

    Full Text Available Context : Pure mucinous carcinoma of the male breast is an extremely rare neoplasm. It is characterized by a lower incidence of metastatic nodal involvement and a higher survival rate than invasive ductal carcinomas. Case Report : We report the case of a 75-year-old male who presented with a retroareolar mass of the right breast. The patient underwent radical mastectomy including right axillary lymph node dissection. The tumor was well demarcated and had a friable consistency with a gelatinous appearance. Histologically, the diagnostic of pure mucinous carcinoma with lymph node metastasis was performed. After surgery, the patient received chemotherapy, radiotherapy, and hormonotherapy (Tamoxifen. The patient remained free of disease for 36 months after surgery. Conclusion : Pure mucinous carcinoma of the male breast is a very rare tumor; in which axillary nodal disease is exceptional.

  10. Solitary pancreatic lymph node metastasis from carcinoma of the breast: case report

    Directory of Open Access Journals (Sweden)

    Scambia Giovanni

    2010-05-01

    Full Text Available Abstract Background We report the first case of isolated pancreatic lymph node recurrence in a locally advanced breast cancer patient. Case A 41-year old woman underwent radical mastectomy according to Madden and removal of axillary lymph nodes for multicentric infiltrating ductal carcinoma pathologically staged as pT2N2M0. After six years from primary diagnosis, and four years from the diagnosis of lung recurrence, she developed an isolated metastatic lesion to pancreatic lymph node. After surgical excision of metastasis, hormone therapy with Exemestane was begun. At 16 months of follow-up, the patient appears free of disease. Conclusion Because metastatization to visceral organ carries a very unfavorable prognosis, we think that the clinical significance of the elevation of CA 15.3 serum levels in the early detection of recurrence and in monitoring metastatic disease during follow-up, should be not underestimated.

  11. Cerebral metastasis from malignant pleural mesothelioma

    OpenAIRE

    El Molla, Mohamed; Gragnaniello, Cristian; Al-Khawaja, Darweesh; Chiribao-Negri, Concepcion; Eftekhar, Behzad

    2013-01-01

    Malignant mesothelioma is an uncommon, highly invasive tumor derived from the mesothelial cells of pleura or peritoneum characterized by poor outcome. Mesothelioma was thought to metastasize locally only via direct invasion and not have distant spread. Distant metastases were discovered mostly on post-mortem examination. The authors present a case of 62-year-old man with pleural mesothelioma and brain metastasis.

  12. Brain fag: New perspectives from case observations.

    Science.gov (United States)

    Ebigbo, Peter O; Lekwas, Elekwachi Chimezie; Chukwunenyem, Nweze Felix

    2015-06-01

    Brain fag was originally described as a culture-bound syndrome among West African students. The term "brain fag" literally means "brain fatigue." Available literature indicates that brain fag symptoms usually present in formal academic settings when African students are required to transit to a reliance on written literature (as opposed to more traditional oral forms of information transmission) and to adapt to westernized, individualistic systems of education that, at times, oppose the values of relatively collectivistic African societies. Based on detailed observation of two typical and two nontypical cases of brain fag, the authors suggest that the syndrome may not be solely related to tensions in the academic sphere, but may function more generally as an expression of psychological distress that results from societal pressures that exceed the coping capacity of the individual. The brain fag symptoms, including lack of concentration, sensations of internal heat in the head and body, heaviness, and multiple somatic complaints, may constitute a defensive process which helps prevent a full-fledged decompensation. PMID:25468825

  13. A Case of Hypopharyngeal Squamous Cell Carcinoma with Peritonead and Liver Metastasis Presenting Acute Abdomen

    Directory of Open Access Journals (Sweden)

    Hashem Sharifian

    2009-01-01

    Full Text Available "nIntroduction: Squamous cell carcinoma (SCC of the head and neck is usually confined to local and regional sites but occasionally patients may present with rare manifestation of distant metastasis. We reported a case of hypopharyngeal SCC with liver and peritoneal metastasis. "nClinical picture: A 50-year-old female with advanced hypopharyngeal SCC was treated in this center by laryngoesophagectomy and gastric pull up. "nOne year later she presented with signs of bowel obstruction. CT scan showed an 11×15 centimeter mass with a large necrotic center in the peritoneal cavity which caused bowel obstruction. "n Some other necrotic masses were seen in the liver too. After surgery, histopathologic examination shows these masses are metastatic SCC. Abdominal fluid showed malignant cells. "nConclusion: These rare and aggressive presentations of SCC of the head and neck remind us that they may show atypical manifestations and may need more aggressive search of the distant disease in at least some subgroups of the head and neck carcinoma. "n"n  

  14. [Surgical Resection for Mediastinal Lymph Node Metastasis of Combined Hepatocellular and Cholangiocarcinoma--A Case Report].

    Science.gov (United States)

    Yoshida, Mitsuhiko; Shimizu, Hiroaki; Ohtsuka, Masayuki; Kato, Atsushi; Yoshitomi, Hideyuki; Furukawa, Katsunori; Takayashiki, Tsukasa; Kuboki, Satoshi; Takano, Shigetsugu; Okamura, Daiki; Suzuki, Daisuke; Sakai, Nozomu; Kagawa, Shingo; Nojima, Hiroyuki; Miyazaki, Masaru

    2015-11-01

    We report the case of a 77-year-old woman with mediastinal lymph node metastasis of combined hepatocellular and cholangiocarcinoma who was successfully treated with S8 segmentectomy and lymphadenectomy. A hepatic nodule was detected in segment 8 during follow-up computed tomography (CT) after left iliac arterial aneurysm repair. The patient was diagnosed with a hepatocellular carcinoma (HCC), and transcatheter arterial chemoembolization (TACE) was selected for HCC because of the patient's condition. The levels of tumor markers did not change after TACE was performed twice. Therefore, TACE treatment was considered to be ineffective for HCC, and the patient was admitted to our hospital for surgical resection. In addition to the primary lesion, a lymph node with a diameter of 20 mm was detected in the anterior mediastinum using CT and magnetic resonance imaging(MRI). We did not find any other metastases, and therefore, S8 segmentectomy and lymphadenectomy in the anterior mediastinum were performed. Recovery was uneventful, and the patient was discharged from the hospital on postoperative day 12. Based on histopathologic findings, combined hepatocellular and cholangiocarcinoma with mediastinal lymph node metastasis was confirmed. Levels of tumor markers normalized, and the patient survived without recurrence for 6 months. PMID:26805196

  15. A Study Evaluating INIPARIB in Combination With Chemotherapy to Treat Triple Negative Breast Cancer Brain Metastasis

    Science.gov (United States)

    2016-02-17

    Estrogen Receptor Negative (ER-Negative) Breast Cancer; Progesterone Receptor Negative (PR-Negative) Breast Cancer; Human Epidermal Growth Factor Receptor 2 Negative (HER2-Negative) Breast Cancer; Brain Metastases

  16. Middle segment-preserving pancreatectomy for recurrent metastasis of renal cell carcinoma after pancreatoduodenectomy: a case report.

    Science.gov (United States)

    Takeshi, Aiyama; Mitsuhiro, Inagaki; Hiromitsu, Akabane; Naoyuki, Yanagida; Taiichiro, Shibaki; Hiroki, Shomura; Takeaki, Kudo; Tatsuya, Shonaka; Futoshi, Oikawa; Hiroharu, Sakurai; Shiro, Nakano

    2014-01-01

    Many cases of surgical resection of metastatic pancreatic tumors originating from renal cell carcinoma have been reported; however, cases of reresection of recurrent pancreatic metastasis of renal cell carcinoma in the remnant pancreas are rare. We performed a second resection for recurrent pancreatic metastasis of renal cell carcinoma six years after pancreatoduodenectomy with pancreaticogastrostomy reconstruction. By performing middle segment-preserving pancreatectomy, we were able to successfully spare the exocrine and endocrine pancreatic function compared to that observed after total pancreatectomy, with no signs of recurrence for two years after the surgery. PMID:25061531

  17. Middle Segment-Preserving Pancreatectomy for Recurrent Metastasis of Renal Cell Carcinoma after Pancreatoduodenectomy: A Case Report

    Science.gov (United States)

    Takeshi, Aiyama; Mitsuhiro, Inagaki; Hiromitsu, Akabane; Naoyuki, Yanagida; Taiichiro, Shibaki; Hiroki, Shomura; Takeaki, Kudo; Tatsuya, Shonaka; Futoshi, Oikawa; Hiroharu, Sakurai; Shiro, Nakano

    2014-01-01

    Many cases of surgical resection of metastatic pancreatic tumors originating from renal cell carcinoma have been reported; however, cases of reresection of recurrent pancreatic metastasis of renal cell carcinoma in the remnant pancreas are rare. We performed a second resection for recurrent pancreatic metastasis of renal cell carcinoma six years after pancreatoduodenectomy with pancreaticogastrostomy reconstruction. By performing middle segment-preserving pancreatectomy, we were able to successfully spare the exocrine and endocrine pancreatic function compared to that observed after total pancreatectomy, with no signs of recurrence for two years after the surgery. PMID:25061531

  18. Patent foramen ovale as a preferential mechanism for increasing the likelihood of brain tumor metastasis

    OpenAIRE

    Rigatelli, Gianluca; Rossi, Andrea; Dell'Avvocata, Fabio; Cardaioli, Paolo

    2011-01-01

    Metastases are the most common tumors of the central nervous system which may lie dormant behind the brain blood- barrier sheltering from chemiotherapeutic drugs, and whose presence usually indicates a poor prognosis. Development of brain metastases includes the intravasation of the cancer cells through the tumor blood vessels, their circulation within the venous system, passing through the pulmonary filter thus reaching the systemic circulation. Patent foramen ovale (PFO) is a natural commun...

  19. Breast cancer surface receptors predict risk for developing brain metastasis and subsequent prognosis

    OpenAIRE

    Grewal, Jai; Kesari, Santosh

    2008-01-01

    Determining the status of breast cancer surface receptors (estrogen receptor, progesterone receptor, HER2/neu) has become routine in the care of patients with this disease and has proven to be helpful in guiding treatment. For this reason, breast cancer has become a model for molecularly guided therapy in solid tumors. Emerging data support that these receptors are associated with risk for developing brain metastases. Additionally, once brain metastases have occurred these receptors may also ...

  20. A multi-institutional outcome and prognostic factor analysis of radiosurgery (RS) for resectable single brain metastasis

    International Nuclear Information System (INIS)

    PURPOSE: Recent randomized trials comparing resection of single brain metastasis (BM) in selected patients (pts) followed by whole brain radiotherapy (WBRT) to WBRT alone demonstrated statistically significant survival advantage for surgery (Patchell, 1990 and Noordijk, 1994). This multi-institutional retrospective study was performed in similar pts who were treated with RS and WBRT to provide a baseline for comparison for a future randomized trial. MATERIALS AND METHODS: The RS databases of four institutions were reviewed to identify all pts who met the following criteria: single BM; age > 18; surgically resectable lesion; independently functional (KPS ≥ 70); non-radiosensitive histology (small cell, lymphoma, myeloma, germ cell excluded); no prior cranial surgery or WBRT. 122 of 533 pts with BM treated with RS met these criteria. Pts were categorized by: (a) status of the primary: 'absent' = complete resection, 26 pts; 'controlled' locally controlled with radiotherapy or chemotherapy, 70 pts; 'under treatment' = undergoing radiotherapy, 15 pts; 'active' = no definitive or successful treatment of the primary, 11 pts; (b) status of non-CNS metastasis: present=64 pts, absent=58 pts; (c) age: median=61, range 23-83; (d) KPS : KPS 70/80/90/100=20/26/44/32 pts; (e) histology: lung=58, melanoma=16, breast=13, renal=12,colon=9, other=10, unknown primary=4; (f) time from primary to BM: median=12 months, range=1-252 months; (g) gender: male=64, female=58; (h) tumor volume: median=2.68 cc, range=0.13-27.2 cc. RS was performed with a linear accelerator based technique (peripheral dose 10-27 Gy, median 17 Gy). WBRT was performed in all but 5 pts who refused it (range 25 - 40 Gy, median 37.5 Gy). RESULTS: The potential median follow-up for all pts is 123 weeks (wks). The overall local response rate is 59% (complete response = 25%, partial response = 34%). In field progression occurred in 17 patients (14%), with overall local control of 86%. Local control was highest for

  1. Multiple brain abscesses: A case report

    Directory of Open Access Journals (Sweden)

    Banić-Horvat Sofija

    2004-01-01

    Full Text Available Case Report 10 days before admission a 45-year old female experienced general weakness, and T 38oC. During that period she had no cardio-respiratory nor neurological complaints, and the temperature varied between 37.5oC and 38oC. Her medical history was unremarkable, without immunodeficiency. The day before admission she presented with left arm paresis and during the next day it progressed to paralysis. She had no headache. On admission the following diagnostic procedures were performed: the cranial CT scan showed two lesions (possibly meta lesions. Chest X-ray was normal. WBC=15x109/L, ESR= 90/120. On the second day following admission brain MRI showed multiple abscesses in both hemispheres, mostly in the gray/white junction. High doses of IV metronidasol, cephtriaxon and cipfloxacin were administered without obtaining specimens for micro- biological diagnosis. In next two days she developed coma, respiratory insufficiency and septic temperature. Brain surgery was not performed due to severe involvement of the brain with multiple abscesses. Repeated chest X-ray revealed bilateral pneumonia. A lethal outcome occurred on the third day, regardless of all efforts. Autopsy showed multiple brain abscesses as well as on the lungs and liver. A beta-hemolytic streptococcal infection was established. Conclusions Prevention includes treatment of the infection source. The classic triad of headache, fever and focal deficit occur in less than 50% of patients. Even in such cases brain abscess must be reconsidered. CT appearance of brain abscess is similar to that of neoplastic and other infectious and non infectious deseases - especially in the stage of early cerebritis. If the CT findings are not clear, MRI should be performed.

  2. The Largest Known Survival Analysis of Patients with Brain Metastasis from Thyroid Cancer Based on Prognostic Groups.

    Directory of Open Access Journals (Sweden)

    Jinhyun Choi

    Full Text Available To analyze the clinical features and prognostic factors associated with the survival of patients with a very rare occurrence of brain metastasis (BM from differentiated thyroid cancer (DTC.A total of 37 patients with DTC who were diagnosed with BM between 1995 and 2014 were included. We reviewed the clinical characteristics, treatment modalities, and image findings of BM. Factors associated with survival were evaluated, and the patients were divided into three prognostic groups (Groups A, B, and C for comparative analysis.The median age at BM was 63 years, and the median time from initial thyroid cancer diagnosis to BM was 3.8 years. The median survival and the 1-year actuarial survival rate after BM were 8.8 months and 47%, respectively. According to univariate and multivariate analyses, four good prognostic factors (GPFs were identified including age ≤ 60 years, PS ≤ ECOG 2, ≤ 3 BM sites, and without extracranial metastasis prior to BM. Three prognostic groups were designed based on age and number of remaining GPFs: patients ≤ 60 years of age with at least 2 GPFs (Group A had the most favorable prognosis with a median survival of 32.8 months; patients ≤ 60 years of age with fewer than 2 GPFs and those > 60 years of age with at least 2 GPFs (Group B had an intermediate prognosis with a median survival of 9.4 months; and patients > 60 years of age with fewer than 2 GPFs (Group C had the least favorable prognosis with a median survival of 1.5 months.The survival of patients with BM form DTC differed among the prognostic groups based on the total number of good prognostic factors.

  3. The Largest Known Survival Analysis of Patients with Brain Metastasis from Thyroid Cancer Based on Prognostic Groups

    Science.gov (United States)

    Choi, Jinhyun; Kim, Jun Won; Keum, Yo Sup; Lee, Ik Jae

    2016-01-01

    Purpose To analyze the clinical features and prognostic factors associated with the survival of patients with a very rare occurrence of brain metastasis (BM) from differentiated thyroid cancer (DTC). Methods and Materials A total of 37 patients with DTC who were diagnosed with BM between 1995 and 2014 were included. We reviewed the clinical characteristics, treatment modalities, and image findings of BM. Factors associated with survival were evaluated, and the patients were divided into three prognostic groups (Groups A, B, and C) for comparative analysis. Results The median age at BM was 63 years, and the median time from initial thyroid cancer diagnosis to BM was 3.8 years. The median survival and the 1-year actuarial survival rate after BM were 8.8 months and 47%, respectively. According to univariate and multivariate analyses, four good prognostic factors (GPFs) were identified including age ≤ 60 years, PS ≤ ECOG 2, ≤ 3 BM sites, and without extracranial metastasis prior to BM. Three prognostic groups were designed based on age and number of remaining GPFs: patients ≤ 60 years of age with at least 2 GPFs (Group A) had the most favorable prognosis with a median survival of 32.8 months; patients ≤ 60 years of age with fewer than 2 GPFs and those > 60 years of age with at least 2 GPFs (Group B) had an intermediate prognosis with a median survival of 9.4 months; and patients > 60 years of age with fewer than 2 GPFs (Group C) had the least favorable prognosis with a median survival of 1.5 months. Conclusions The survival of patients with BM form DTC differed among the prognostic groups based on the total number of good prognostic factors. PMID:27128487

  4. Breast Metastasis in Esophagus Cancer: Literature Review and Report on a Case

    Science.gov (United States)

    2016-01-01

    Esophagus cancer metastases often involve locoregional lymph nodes, lung, bone, liver, and brain. Metastatic involvement of the breast from esophagus cancer is uncommon, but if it happened, it usually presents as a part of multiple organ distal metastases. Here we report a case of the largest metastatic esophagus cancer of the breast and the chest wall, and we review the similar reported cases. PMID:27340587

  5. Traumatic Neuroma around the Celiac Trunk after Gastrectomy Mimicking a Nodal Metastasis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Jung Hyeok; Ryu, Seung Wan; Kang, Yu Na [Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2007-06-15

    Traumatic neuroma is a well-known disorder that occurs after trauma or surgery involving the peripheral nerve and develops from a nonneoplastic proliferation of the proximal end of a severed, partially transected, or injured nerve. However, in the abdomen, traumatic neuromas have been sporadically reported to occur in the bile duct. We present here a case of traumatic neuroma around the celiac trunk after gastrectomy that mimicks a nodal metastasis. In conclusion, the imaging finding of traumatic neuroma around the celiac trunk was a homogeneous hypovascular mass without narrowing or irregularity of encased arteries and without increased uptake on PET-CT. Although from a clinical standpoint, establishing an accurate preoperative diagnosis is difficult to perform, the presence of a traumatic neuroma should be included in the differential diagnosis of a mass around the celiac trunk in a patient that has undergone celiac nodal dissection.

  6. Percutaneous vertebral augmentation for painful osteolytic vertebral metastasis: a case report

    Directory of Open Access Journals (Sweden)

    Anselmetti GC

    2012-03-01

    Full Text Available Giovanni C Anselmetti1, Sean M Tutton2, Francis R Facchini3, Larry E Miller4,5, Jon E Block51Institute for Cancer Research and Treatment, Turin, Italy; 2Medical College of Wisconsin in Milwaukee, Froedtert Memorial Lutheran Hospital, Milwaukee, WI, USA; 3Interventional Radiology, Interventional Oncology, VIR Chicago, Hinsdale, IL, USA; 4Miller Scientific Consulting, Inc, Arden, NC, USA; 5The Jon Block Group, San Francisco, CA, USAIntroduction: Vertebral metastases are associated with significant pain, disability, and morbidity. Open surgery for fracture stabilization is often inappropriate in this population due to a poor risk-benefit profile, particularly if life expectancy is short. Percutaneous vertebroplasty and kyphoplasty are appealing adjunctive procedures in patients with malignancy for alleviation of intractable pain. However, these patients have higher risk of serious complications, notably cement extravasation. Described in this report is a case of a painful osteolytic vertebral metastasis that was successfully treated by a novel percutaneous vertebral augmentation system.Case presentation: A 42-year-old Caucasian female presented with a history of metastatic lung cancer unresponsive to radiation and chemotherapy with symptoms inadequately controlled by opiates over the previous 6 months. Magnetic resonance imaging and spiral computed tomography with two-dimensional reconstruction showed an osteolytic vertebral metastasis with complete involvement of the T10 vertebral body, extending to the cortical vertebral wall anteriorly and posteriorly. The patient was treated with percutaneous vertebral augmentation (Kiva® VCF Treatment System, Benvenue Medical, Inc, Santa Clara, CA utilizing a novel coil-shaped polyetheretherketone implant designed to minimize the risk of cement extravasation. After the minimally invasive procedure, bone cement distribution within the vertebral body was ideal, with no observed cement extravasation. No

  7. Assessment of the Molecular Expression and Structure of Gangliosides in Brain Metastasis of Lung Adenocarcinoma by an Advanced Approach Based on Fully Automated Chip-Nanoelectrospray Mass Spectrometry

    Science.gov (United States)

    Zamfir, Alina D.; Serb, Alina; Vukeli, Željka; Flangea, Corina; Schiopu, Catalin; Fabris, Dragana; Kalanj-Bognar, Svjetlana; Capitan, Florina; Sisu, Eugen

    2011-12-01

    Gangliosides (GGs), sialic acid-containing glycosphingolipids, are known to be involved in the invasive/metastatic behavior of brain tumor cells. Development of modern methods for determination of the variations in GG expression and structure during neoplastic cell transformation is a priority in the field of biomedical analysis. In this context, we report here on the first optimization and application of chip-based nanoelectrospray (NanoMate robot) mass spectrometry (MS) for the investigation of gangliosides in a secondary brain tumor. In our work a native GG mixture extracted and purified from brain metastasis of lung adenocarcinoma was screened by NanoMate robot coupled to a quadrupole time-of-flight MS. A native GG mixture from an age-matched healthy brain tissue, sampled and analyzed under identical conditions, served as a control. Comparative MS analysis demonstrated an evident dissimilarity in GG expression in the two tissue types. Brain metastasis is characterized by many species having a reduced N-acetylneuraminic acid (Neu5Ac) content, however, modified by fucosylation or O-acetylation such as Fuc-GM4, Fuc-GM3, di- O-Ac-GM1, O-Ac-GM3. In contrast, healthy brain tissue is dominated by longer structures exhibiting from mono- to hexasialylated sugar chains. Also, significant differences in ceramide composition were discovered. By tandem MS using collision-induced dissociation at low energies, brain metastasis-associated GD3 (d18:1/18:0) species as well as an uncommon Fuc-GM1 (d18:1/18:0) detected in the normal brain tissue could be structurally characterized. The novel protocol was able to provide a reliable compositional and structural characterization with high analysis pace and at a sensitivity situated in the fmol range.

  8. Colonic metastasis of Klatskin tumor: Case report and discussion of the current literature

    Institute of Scientific and Technical Information of China (English)

    M Schmeding; U Neumann; P Neuhaus

    2006-01-01

    We report the case of a 65-year old male patient who initially presented with recurrent episodes of upper abdominal pain, lack of appetite and weight loss.Abdominal ultrasound indicated enlarged intrahepatic bile ducts, abdominal CT scan and ERC were performed and bile duct carcinoma (Klatskin Type Ⅲ b) was diagnosed. The tumor was located in the segments 2,3,4 and 1 with possible invasion of the left intrahepatic portal vein. Both the segments 2 and 3 of the liver were atrophic and displayed a cholestatic bile duct system. Preoperatively an intraductal stent was placed in the left bile duct using ERC to drain the left hepatic lobe. A specimen of the ascites present preoperatively displayed no malignant cells. After evaluation of the preoperatively obtained data left hepatic resection was planned. Following laparotomy we found local peritoneal carcinosis in the ligamentum hepatoduodenale with lymphatic nodules that tested positive for cholangiocellular carcinoma in online pathological examination. In the course of further exploration of the abdomen a solid tumor was detected in the sigmoid colon. Regarding the advanced stage of the neoplasm it was decided to cancel hemihepatectomy and perform sigmoid resection only in order to guarantee uncomplicated intestinal passage. The sigmoid colon was removed by a typical resection technique with endto-end anastomosis. Histological examination of the resected sigmoid revealed transmural manifestation of a malignant neoplastic process with both a tubular and a solid growth pattern in conformity with metastasis of a Klatskin tumor. The mucosal layer showed no neoplastic alteration. Peritoneal carcinosis is a common phenomenon in the dissemination pattern of advancedstage Klatskin tumors, yet to our knowledge this is the first case of intramural colonic growth following peritoneal metastasis.

  9. In vivo MRI of cancer cell fate at the single-cell level in a mouse model of breast cancer metastasis to the brain.

    Science.gov (United States)

    Heyn, Chris; Ronald, John A; Ramadan, Soha S; Snir, Jonatan A; Barry, Andrea M; MacKenzie, Lisa T; Mikulis, David J; Palmieri, Diane; Bronder, Julie L; Steeg, Patricia S; Yoneda, Toshiyuki; MacDonald, Ian C; Chambers, Ann F; Rutt, Brian K; Foster, Paula J

    2006-11-01

    Metastasis (the spread of cancer from a primary tumor to secondary organs) is responsible for most cancer deaths. The ability to follow the fate of a population of tumor cells over time in an experimental animal would provide a powerful new way to monitor the metastatic process. Here we describe a magnetic resonance imaging (MRI) technique that permits the tracking of breast cancer cells in a mouse model of brain metastasis at the single-cell level. Cancer cells that were injected into the left ventricle of the mouse heart and then delivered to the brain were detectable on MR images. This allowed the visualization of the initial delivery and distribution of cells, as well as the growth of tumors from a subset of these cells within the whole intact brain volume. The ability to follow the metastatic process from the single-cell stage through metastatic growth, and to quantify and monitor the presence of solitary undivided cells will facilitate progress in understanding the mechanisms of brain metastasis and tumor dormancy, and the development of therapeutics to treat this disease. PMID:17029229

  10. Thyroid carcinoma presenting as a dural metastasis mimicking a meningioma: A case report

    Directory of Open Access Journals (Sweden)

    El Mehdi Tazi

    2011-01-01

    Full Text Available Context: Follicular thyroid cancer rarely manifests itself as a distant metastatic lesion. Case Report: We report a case of a 41-year old man presented with a solid mass located in the left temporo-occipital region. The 3D computed tomography showed a large solid mass with high vascularity, skull erosion and supra-infratentorial epidural mass effect. After magnetic resonance imaging (MRI a suspect diagnosis of meningioma was made. The patient underwent surgery where a soft mass with transverse sinus invasion was encountered; the tumour was successfully resected employing microsurgical techniques. Histological examination revealed a thyroid follicular neoplasm with positive staining for follicular carcinoma in immunohistochemical analysis. Postoperatively levels of thyroid hormones were normal. Treatment was planned for the thyroid gland, patient receiving 6 courses of chemotherapy including paclitaxel. Conclusions: The present case emphasizes that although they are uncommon, dural metastasis can be mistaken for meningiomas. The definitive diagnosis of a meningioma should be established only after the histopathological analysis. Thyroid follicular carcinoma should be included in the differential diagnosis in cases of extrinsic tumoral lesions.

  11. Breast cancer metastasis to the vulva 20 years remote from initial diagnosis: A case report and literature review

    OpenAIRE

    Alligood-Percoco, Natasha R.; Kessler, Meghan S.; Gregory Willis

    2015-01-01

    Highlights • This is the 20th documented case of metastatic breast carcinoma to the vulva. • Greater than 21 years have passed from initial diagnosis to vulvar metastasis. • Existing literature supports long term surveillance in women with invasive lobular carcinoma of the breast.

  12. Leptomeningeal metastasis from hepatocellular carcinoma with other unusual metastases: a case report

    OpenAIRE

    Pan, Zhenyu; Yang, Guozi; Yuan, Tingting; Pang, Xiaochuan; Wang, Yongxiang; QU, LIMEI; Dong, Lihua

    2014-01-01

    Background Leptomeningeal metastasis, which results from metastasis of tumors to the arachnoid and pia mater, can lead to the dissemination of tumor cells throughout the subarachnoid space via the cerebral spinal fluid, and frequently with a poor prognosis. The primary tumor in adults is most often breast cancer, lung cancer, or melanoma. Although leptomeningeal metastasis due to cholangiocarcinoma has been reported, to the best of our knowledge there is no cytologically confirmed report of l...

  13. Abdominal wall metastasis of uterine papillary serous carcinoma in a post-menopausal woman: a case report.

    Science.gov (United States)

    Park, Jung-Woo; Hwang, Sung-Ook

    2014-04-01

    Uterine papillary serous carcinoma (UPSC) is an aggressive form of endometrial cancer characterized by a high recurrence rate and poor prognosis. We report a case of a 58-year-old post-menopausal woman with an abdominal wall metastasis in stage IA UPSC. After surgical staging, she did not receive additional adjuvant therapy. An egg sized palpable mass developed in the right lower abdomen after 8 months. Both Abdominopelvic computed tomography (CT) and positron emission tomography (PET)-CT revealed a metastatic lesion in the abdominal wall. Hence, surgical excision was performed. The pathological findings showed metastatic UPSC with clear resection margin. After the diagnosis of UPSC metastasis in the abdominal wall, she received chemotherapy utilizing paclitaxel and carboplatin. After 3 years, no evidence of recurrence was found. Therefore, we suggest that even when UPSC is confined to the endometrium without lymph node metastasis and without lymphovascular invasion, chemotherapy should be considered as a postoperative adjuvant therapy. PMID:25371890

  14. Solitary axillary lymph node metastasis without breast involvement from ovarian Cancer: Case report and brief literature review

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Ji In; Kim, Soo Jin; Park, Sung Hee; Kim, Hee Sung [Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul (Korea, Republic of)

    2014-11-15

    Axillary lymph node metastasis without breast involvement from ovarian cancer is rare. We report a case of a 68-year-old woman proven as ovarian serous papillary carcinoma and metastatic papillary carcinoma of the omentum on surgical diagnostic laparoscopy. In addition, a hypermetabolic lymph node was detected in left axilla and was considered a reactive benign lesion. Mammography and ultrasonography showed no focal lesion in both breasts, but ultrasonography-guided core needle biopsy for the lymph node revealed metastatic serous papillary carcinoma from ovarian origin. Even with a low incidence of axillary lymph node metastasis without breast involvement from ovarian cancer and only marginally elevated standardized uptake value in positron emission tomography, the possibility of metastasis at axillary lymph node in patients with known primary ovarian cancer must be considered.

  15. Solitary axillary lymph node metastasis without breast involvement from ovarian Cancer: Case report and brief literature review

    International Nuclear Information System (INIS)

    Axillary lymph node metastasis without breast involvement from ovarian cancer is rare. We report a case of a 68-year-old woman proven as ovarian serous papillary carcinoma and metastatic papillary carcinoma of the omentum on surgical diagnostic laparoscopy. In addition, a hypermetabolic lymph node was detected in left axilla and was considered a reactive benign lesion. Mammography and ultrasonography showed no focal lesion in both breasts, but ultrasonography-guided core needle biopsy for the lymph node revealed metastatic serous papillary carcinoma from ovarian origin. Even with a low incidence of axillary lymph node metastasis without breast involvement from ovarian cancer and only marginally elevated standardized uptake value in positron emission tomography, the possibility of metastasis at axillary lymph node in patients with known primary ovarian cancer must be considered.

  16. Right axillary lymph node metastasis of carcinoma of the cecum with histologically proven cutaneous lymphatic invasion by carcinoma cells: a case report

    OpenAIRE

    Kawamura, Yutaka J.; Kohno, Michitaka; Shiga, Junji; Asakage, Naoki; Hatano, Minoru; Okame, Hirohisa; SASAKI, JUNICHI; Tobari, Shoichi; Nishida, Katsunori

    2015-01-01

    Axillary lymph node metastasis from colorectal carcinoma is extremely rare, and this scarcity hinders understanding of its pathogenesis and, thus, the application of appropriate management. Here, we present a case with axillary lymph node metastasis of cecal carcinoma associated with macroscopic invasion of the skin of the abdominal wall with histological evidence of such invasion, findings which support our hypothesis that the axillary lymph node metastasis developed via the lymph channels i...

  17. Medical and health economic assessment of radiosurgery for the treatment of brain metastasis

    OpenAIRE

    von der Schulenburg, Johann-Matthias; Willich, Stefan N.; Vauth, Christoph; Ernst, Iris; Schwarzbach, Christoph; Bockelbrink, Angelina; Müller-Riemenschneider, Falk

    2009-01-01

    Background Radiotherapy for patients suffering from malignant neoplasms has developed greatly during the past decades. Stereotactic radiosurgery (SRS) is one important radiotherapeutic option which is defined by a single and highly focussed application of radiation during a specified time interval. One of its important indications is the treatment of brain metastases . Objectives The objective of this HTA is to summarise the current literature concerning the treatment of b...

  18. Prostate cancer with metastasis in the fibula. Presentation of a Case.

    Directory of Open Access Journals (Sweden)

    Horacio Suárez Monzón

    2007-12-01

    Full Text Available The case of a 70 years old patient of masculine sex is presented. After having suffered a traumatism in the left inferior limb and having fulfilled the suitable treatment, the patient presented new signs and symptoms that led him to the department of Orthopedics and Traumatology. With the initial exams and treatment no improvement was obtained, thus doctors decided to opt for the surgical treatment. It could be observed the presence of an osteolytic lesion of approximately 5 cm and the pertinent samples were taken to carry out biopsies of the muscle and the bone. Results didn't lead to a definitive diagnosis. The result of new exams required an inter-consult with the Service of Urology, to obtain the diagnosis of prostatic adenocarcinoma. The revision of the national and international literature didn't report any similar case; the atypical localization of the metastasis is what led to the preparation of the case for its knowledge and diffusion, for what it can contribute to the experience of professionals specialized in orthopedics or urology.

  19. Concomitant treatment of brain metastasis with Whole Brain Radiotherapy [WBRT] and Temozolomide [TMZ] is active and improves Quality of Life

    International Nuclear Information System (INIS)

    Brain metastases (BM) represent one of the most frequent complications related to cancer, and their treatment continues to evolve. We have evaluated the activity, toxicity and the impact on Quality of Life (QoL) of a concomitant treatment with whole brain radiotherapy (WBRT) and Temozolomide (TMZ) in patients with brain metastases from solid tumors in a prospective Simon two stage study. Fifty-nine patients were enrolled and received 30 Gy WBRT with concomitant TMZ (75 mg/m2/day) for ten days, and subsequently TMZ (150 mg/m2/day) for up to six cycles. The primary end points were clinical symptoms and radiologic response. Five patients had a complete response, 21 patients had a partial response, while 18 patients had stable disease. The overall response rate (45%) exceeded the target activity per study design. The median time to progression was 9 months. Median overall survival was 13 months. The most frequent toxicities included grade 3 neutropenia (15%) and anemia (13%), and only one patient developed a grade 4 thrombocytopenia. Age, Karnofsky performance status, presence of extracranial metastases and the recursive partitioning analysis (RPA) were found to be predictive factors for response in patients. Overall survival (OS) and progression-free survival (PFS) were dependent on age and on the RPA class. We conclude that this treatment is well tolerated, with an encouraging objective response rate, and a significant improvement in quality of life (p < 0.0001) demonstrated by FACT-G analysis. All patients answered the questionnaires and described themselves as 'independent' and able to act on their own initiatives. Our study found a high level of satisfaction for QoL, this provides useful information to share with patients in discussions regarding chemotherapy treatment of these lesions

  20. Brain Metastasis is Predetermined in Early-Stages of Cutaneous Melanoma by CD44v6 Expression through Epigenetic Regulation of the Spliceosome

    OpenAIRE

    Marzese, Diego M.; Liu, Michelle; Huynh, Jamie L.; Hirose, Hajime; Donovan, Nicholas C.; Huynh, Kelly T.; Kiyohara, Eiji; Chong, Kelly; Cheng, David; Tanaka, Ryo; Morton, Donald L.; Barkhoudarian, Garni; Daniel F. Kelly; Hoon, Dave S.B.

    2014-01-01

    Melanoma brain metastasis (MBM) is frequent and has a very poor prognosis with no current predictive factors or therapeutic molecular targets. Our study unravels the molecular alterations of cell-surface glycoprotein CD44 variants during melanoma progression to MBM. High expression of CD44 splicing variant 6 (CD44v6) in primary melanoma (PRM) and regional lymph node metastases from AJCC Stage IIIC patients significantly predicts MBM-development. The expression of CD44v6 also enhances the migr...

  1. Differentiation of solitary brain metastasis from glioblastoma multiforme: a predictive multiparametric approach using combined MR diffusion and perfusion

    International Nuclear Information System (INIS)

    Solitary brain metastasis (MET) and glioblastoma multiforme (GBM) can appear similar on conventional MRI. The purpose of this study was to identify magnetic resonance (MR) perfusion and diffusion-weighted biomarkers that can differentiate MET from GBM. In this retrospective study, patients were included if they met the following criteria: underwent resection of a solitary enhancing brain tumor and had preoperative 3.0 T MRI encompassing diffusion tensor imaging (DTI), dynamic contrast-enhanced (DCE), and dynamic susceptibility contrast (DSC) perfusion. Using co-registered images, voxel-based fractional anisotropy (FA), mean diffusivity (MD), Ktrans, and relative cerebral blood volume (rCBV) values were obtained in the enhancing tumor and non-enhancing peritumoral T2 hyperintense region (NET2). Data were analyzed by logistic regression and analysis of variance. Receiver operating characteristic (ROC) analysis was performed to determine the optimal parameter/s and threshold for predicting of GBM vs. MET. Twenty-three patients (14 M, age 32-78 years old) met our inclusion criteria. Pathology revealed 13 GBMs and 10 METs. In the enhancing tumor, rCBV, Ktrans, and FA were higher in GBM, whereas MD was lower, neither without statistical significance. In the NET2, rCBV was significantly higher (p = 0.05) in GBM, but MD was significantly lower (p < 0.01) in GBM. FA and Ktrans were higher in GBM, though not reaching significance. The best discriminative power was obtained in NET2 from a combination of rCBV, FA, and MD, resulting in an area under the curve (AUC) of 0.98. The combination of MR diffusion and perfusion matrices in NET2 can help differentiate GBM over solitary MET with diagnostic accuracy of 98 %. (orig.)

  2. Differentiation of solitary brain metastasis from glioblastoma multiforme: a predictive multiparametric approach using combined MR diffusion and perfusion

    Energy Technology Data Exchange (ETDEWEB)

    Bauer, Adam Herman; Moser, Franklin G.; Maya, Marcel [Cedars-Sinai Medical Center, Department of Medical Imaging, Los Angeles, CA (United States); Erly, William; Nael, Kambiz [University of Arizona Medical Center, Department of Medical Imaging, Tucson, AZ (United States)

    2015-07-15

    Solitary brain metastasis (MET) and glioblastoma multiforme (GBM) can appear similar on conventional MRI. The purpose of this study was to identify magnetic resonance (MR) perfusion and diffusion-weighted biomarkers that can differentiate MET from GBM. In this retrospective study, patients were included if they met the following criteria: underwent resection of a solitary enhancing brain tumor and had preoperative 3.0 T MRI encompassing diffusion tensor imaging (DTI), dynamic contrast-enhanced (DCE), and dynamic susceptibility contrast (DSC) perfusion. Using co-registered images, voxel-based fractional anisotropy (FA), mean diffusivity (MD), K{sup trans}, and relative cerebral blood volume (rCBV) values were obtained in the enhancing tumor and non-enhancing peritumoral T2 hyperintense region (NET2). Data were analyzed by logistic regression and analysis of variance. Receiver operating characteristic (ROC) analysis was performed to determine the optimal parameter/s and threshold for predicting of GBM vs. MET. Twenty-three patients (14 M, age 32-78 years old) met our inclusion criteria. Pathology revealed 13 GBMs and 10 METs. In the enhancing tumor, rCBV, K{sup trans}, and FA were higher in GBM, whereas MD was lower, neither without statistical significance. In the NET2, rCBV was significantly higher (p = 0.05) in GBM, but MD was significantly lower (p < 0.01) in GBM. FA and K{sup trans} were higher in GBM, though not reaching significance. The best discriminative power was obtained in NET2 from a combination of rCBV, FA, and MD, resulting in an area under the curve (AUC) of 0.98. The combination of MR diffusion and perfusion matrices in NET2 can help differentiate GBM over solitary MET with diagnostic accuracy of 98 %. (orig.)

  3. A case series of neuroendocrine (carcinoid tumor metastasis to the orbit

    Directory of Open Access Journals (Sweden)

    Kiran Turaka

    2011-01-01

    Conclusion : All four patients with orbital metastasis from neuroendocine tumor had evidence of systemic extraorbital metastasis. Aggressive metastatic neuroendocine tumors of orbit can lead to local recurrence even after surgical excision and radiation. Imaging tests were helpful in allowing early diagnosis and for monitoring after treatment.

  4. Solitary osseous metastasis of rectal carcinoma masquerading as osteogenic sarcoma on post-chemotherapy imaging: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Udare, Amar; Sable, Nilesh; Kumar, Rajiv; Thakur, Meenakshi; Juvekar, Shashikant [Tata Memorial Hospital, Mumbai (India)

    2015-02-15

    Solitary metastases from colorectal carcinoma in the absence of hepatic or pulmonary metastases are rare. These can have a diverse imaging appearance, particularly after chemotherapy. It is important identify patients with solitary skeletal metastases, as they have a better prognosis than those with multiple skeletal or visceral metastases. We describe an unusual case of a solitary metastasis to the femur in a case of colon carcinoma that went undiagnosed and later presented with imaging features of osteogenic sarcoma.

  5. Longitudinally Extensive Transverse Myelitis with Intramedullary Metastasis of Small-Cell Lung Carcinoma: An Autopsy Case Report

    OpenAIRE

    Kenya Nishioka; Ryota Tanaka; Satoshi Tsutsumi; Hideki Shimura; Yutaka Oji; Harumi Saeki; Yukimasa Yasumoto; Masanori Ito; Nobutaka Hattori; Takao Urabe

    2013-01-01

    Background. Longitudinally extensive transverse myelitis (LETM) is characterized by spinal cord inflammation extending vertically through three or more vertebral segments. The widespread use of MRI revealed LETM more frequency than ever. We report the case of a patient with pathologically confirmed small-cell lung carcinoma metastasis into the spinal cord presenting as LETM. Case Presentation. A 74-year-old man developed rapidly progressive sensorimotor disturbance and vesicorectal dysfunctio...

  6. Hepatic tuberculosis mimicking metastasis in a case of carcinoma sigmoid colon

    Directory of Open Access Journals (Sweden)

    Musharraf Husain

    2015-01-01

    Full Text Available Tuberculosis (TB presenting as isolated liver mass without clinical evidence of TB is difficult to diagnose preoperatively and is usually mimicked by primary or metastatic carcinoma of the liver. Hepatic TB associated with carcinoma colon is a rare association which has very rarely been reported in the literature. This case illustrates the diagnostic difficulties of hepatic TB and the need to consider it in the differential diagnosis of hepatic nodular lesions in carcinoma colon patients. Here, we report a case of 48-year-old female who presented in the casualty with features of acute intestinal obstruction. Preoperatively a mass was seen at the hepatic flexure along with three lesions in the liver presumed to be metastatic in origin. However, histopathology of the mass revealed adenocarcinoma colon and the liver lesion proved to be hepatic TB. We wish to highlight that on encountering a hepatic lesion in a carcinoma colon patient the possibility of hepatic TB should also be kept in mind apart from the obvious possibility of metastasis especially in an endemic country like India.

  7. Curative resection for leiomyosarcoma of the descending mesocolon with metachronous liver metastasis: A case report and literature review

    Science.gov (United States)

    KATO, TAKAHARU; NODA, HIROSHI; ABE, IKU; ALONSO, SERGIO; YOKOYAMA, NOBU; RIKIYAMA, TOSHIKI

    2016-01-01

    Mesenteric leiomyosarcoma is a rare disease with poor prognosis. Previously, mesenteric leiomyosarcoma was not differentiated from gastrointestinal stromal tumor (GIST), which is the most common mesenchymal tumor of the gastrointestinal tract, and several cases of GIST may have been misclassified as mesenteric leiomyosarcoma. Thus, the actual clinicopathological characteristics of mesenteric leiomyosarcomas remain unclear. We herein describe a case of leiomyosarcoma arising in the descending mesocolon in a patient who developed metachronous liver metastasis. A 76-year-old woman reported a mass in her left upper abdomen. Computed tomography imaging revealed a low-density tumor adjacent to the descending colon. The patient underwent surgery and the tumor was resected along with part of the descending colon. Immunohistochemical differential diagnosis revealed that the tumor was positive for smooth muscle actin and desmin, and negative for CD117 (c-KIT) and S-100, which are characteristic of gastrointestinal leiomyosarcoma. A single liver metastasis developed 24 months after the operation. The patient underwent curative resection of the metastatic lesion. Sixteen months following surgery for the liver metastasis and 40 months after the initial removal of the primary lesion, the patient remains disease-free. The prognosis of leiomyosarcoma remains poor and standardized chemotherapy for this rare disease has not yet been established. Early diagnosis and surgical removal of the tumor is the only potentially curative option for liver metastasis of mesenteric leiomyosarcoma. PMID:27330765

  8. Efficacy of icotinib versus traditional chemotherapy as first-line treatment for preventing brain metastasis from advanced lung adenocarcinoma in patients with epidermal growth factor receptor-sensitive mutation

    Directory of Open Access Journals (Sweden)

    Xiao Zhao

    2014-01-01

    Full Text Available Objective: This study aimed to investigate the potential use of icotinib as first-line treatment to prevent brain metastasis from advanced lung adenocarcinoma. Patients and Methods: This investigation was designed as a retrospective nonrandomized controlled study. Enrolled patients received either icotinib or traditional chemotherapy as their first-line treatment. The therapeutic efficacy was compared among patients with advanced (stages IIIB and IV lung adenocarcinoma with epidermal growth factor receptor (EGFR-sensitive mutation. The primary endpoint was the cumulative incidence of brain metastasis, whereas the secondary endpoint was overall survival (OS. Death without brain metastasis was considered a competitive risk to calculate the cumulative risk of brain metastasis. Survival analysis was conducted using the Kaplan-Meier method and statistical significance were determined using the log-rank test. Results: The present study included 396 patients with 131 in the icotinib group and 265 in the chemotherapy group. Among those with EGFR-sensitive mutation, the cumulative risk of brain metastasis was lower in the icotinib group than in the chemotherapy group. However, no significant difference in OS was observed between the two groups. Conclusion: Icotinib can effectively reduce the incidence of brain metastasis and therefore improve prognosis in advanced lung adenocarcinoma patients with EGFR-sensitive mutation.

  9. Spinal subdural metastasis

    International Nuclear Information System (INIS)

    A case of metastasis to the thoracic spinal subdural space is reported. Metrizamide myelography showed narrowing of the upper thoracic subarachnoid space. A tumor in the spinal subdural space is unusual; only a few cases have been reported. The myelographic appearance is not specific; and epidural metastasis can produce the same myelographic picture. (orig.)

  10. AEG-1与CXCR4对乳腺癌脑转移的影响%Effect of AEG-1 and CXCR4 Gene on Breast Cancer Brain Metastasis

    Institute of Scientific and Technical Information of China (English)

    曲明阳; 李森; 赵胜男; 邢光明

    2011-01-01

    目的 探讨AEG-1与CXCR4基因表达对乳腺癌脑转移的影响.方法 对1997~2007年收治的乳腺癌患者进行随访,以发生脑转移的33例患者作为病例组,以未发生脑转移的45例患者作为对照组.通过免疫组化法,对照分析AEG-1及CXCR4对脑转移的影响.结果 脑转移组中AEG-1及CXCR4的阳性表达率分别为63.6%和60.6%,与其在对照组中表达(31.1%和33.3%)差异显著(P<0.05).logistic回归分析结果显示,AEG-1和CXCR4回归系数分别为1.242和1.545.结论 AEG-1和CXCR4阳性表达是乳腺癌发生脑转移的独立危险因子,AEG-1及CXCR4有望成为针对乳腺癌脑转移的高特异性早期诊断指标及基因治疗靶点.%Objective Explore the effect of AEG-1 and CXCR4 gene on brain metastasis in breast cancer. Methods 33 breast cancer patients with brain metastasis and 45 patients without brain metastasis in our hospital from 1997 to 2007 were chosen randomly for the case control study by immunohisto chemical method. Results the expression rate for AEG-land CXCR4 in the two groups were 63. 6% ,60. 6% and 31. 1% ,33. 3% respectively,with a notebly difference be observed, the regression coefficient for AEG-1 and CXCR4 was 1. 242 and 1. 545. Conclusion AEG-1 and CXCR4 were independent risk factors and may be specific diagnosis index and gene treatment taget for brain metastasis in breast cancer.

  11. Pharmacologic Inhibition of MLK3 Kinase Activity Blocks the In Vitro Migratory Capacity of Breast Cancer Cells but Has No Effect on Breast Cancer Brain Metastasis in a Mouse Xenograft Model

    OpenAIRE

    Rhoo, Kun Hyoe; Granger, Megan; Sur, Joynita; Feng, Changyong; Gelbard, Harris A.; Dewhurst, Stephen; Polesskaya, Oksana

    2014-01-01

    Brain metastasis of breast cancer is an important clinical problem, with few therapeutic options and a poor prognosis. Recent data have implicated mixed lineage kinase 3 (MLK3) in controlling the in vitro migratory capacity of breast cancer cells, as well as the metastasis of MDA-MB-231 breast cancer cells from the mammary fat pad to distant lymph nodes in a mouse xenograft model. We therefore set out to test whether MLK3 plays a role in brain metastasis of breast cancer cells. To address thi...

  12. Isolated Supraclavicular Lymph Node Metastasis in Pancreatic Adenocarcinoma: A Report of Three Cases and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Arundhati D Soman

    2010-11-01

    Full Text Available Context Supraclavicular lymph nodes represent a rare site of metastasis in pancreatic cancer. We report three cases of pancreatic adenocarcinoma with metastases to supraclavicular lymph nodes. Case report A 51-year-old male was diagnosed with locally advanced pancreatic adenocarcinoma on computed tomography (CT scan. He was recommended neoadjuvant chemotherapy followed by chemoradiation therapy. However, positron emission tomography (PET/CT scans and subsequent fine needle aspiration cytology showed supraclavicular lymph node metastasis. The patient received systemic chemotherapy for metastatic pancreatic adenocarcinoma. The second patient, a 66-year-old female with pancreatic adenocarcinoma, underwent pancreaticoduodenectomy and was found to have peripancreatic lymph node involvement. She received adjuvant chemotherapy and was followed-up with surveillance CT scans, which did not reveal any metastasis. However, the patient complained of neck swelling. PET/CT scan and biopsy revealed supraclavicular lymph node metastasis from a pancreatic adenocarcinoma primary. The third patient, a 79-year-old male with a past history of thyroid carcinoma who was treated with partial thyroidectomy, developed neck swelling 4 years after his surgery. Fine needle aspiration cytology was consistent with known papillary thyroid carcinoma. Staging evaluations revealed a pancreatic mass for which he underwent subtotal pancreatectomy and splenectomy. Histopathology revealed grade 3 pancreatic adenocarcinoma. Excisional biopsy of a supraclavicular lymph node showed metastatic pancreatic adenocarcinoma. PET/CT results were consistent with these findings. Conclusion In patients with pancreatic adenocarcinoma, supraclavicular lymph node metastasis represents an uncommon, but clinically significant finding that can lead to changes in treatment planning. PET imaging represents a valuable tool in the detection and follow up of these patients.

  13. Brain metastasis of Wilms tumor with diffuse anaplasia and complex cytogenetic phenotype in a child with neurofibromatosis Type 1.

    Science.gov (United States)

    Shvartsbeyn, Marianna; Bassani, Luigi; Mikolaenko, Irina; Wisoff, Jeffrey H

    2011-10-01

    The authors report the first case of a Wilms tumor (WT) with diffuse anaplasia metastatic to the brain in a 13-year-old girl with a history of neurofibromatosis Type 1. At presentation, the metastatic tumor had radiological features that suggested a meningioma. Histologically it was characterized by striking anaplasia and features similar to the patient's previously resected WT with diffuse anaplasia. PMID:21961578

  14. Single sternal metastasis due to malignant melanoma with unexpected long-term survival: a case report

    Directory of Open Access Journals (Sweden)

    Gogakos AS

    2016-01-01

    Full Text Available Apostolos S Gogakos,1 Dimitrios Paliouras,1 Christos Asteriou,1 Thomas Rallis,1 Achilleas Lazopoulos,1 Fotios Chatzinikolaou,2 Athanassios Zissimopoulos,3 Drosos Tsavlis,4 Katerina Tsirgogianni,4 Konstantinos Zarogoulidis,4 Konstantinos Porpodis,4 Kosmas Tsakiridis,5 Georgia Pitsiou,4 Ioannis Kioumis,4 Ilias Karapantzos,6 Chrysanthi Karapantzou,6 Nikos Sachpekidis,5 Paul Zarogoulidis,4 Nikolaos Barbetakis1 1Thoracic Surgery Department, 2Department of Pathology, Theagenio Cancer Hospital, Thessaloniki, 3Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, 4Pulmonary Department – Oncology Unit, “G. Papanikolaou” General Hospital, Aristotle University of Thessaloniki, 5Cardiothoracic Surgery Department, 6Ear, Nose and Throat Department, “Saint Luke” Private Hospital, Panorama, Thessaloniki, Greece Abstract: Metastases from melanoma have a very poor prognosis for the patient. Single metastatic lesions in the sternum due to melanoma are extremely rare. A rare case of a presternal mass in a 56-year-old patient who had undergone excision for malignant melanoma is presented. Review of the patient’s history and surgical resection of a single metastatic soft tissue lesion offer the best chance of long-term survival. Keywords: melanoma, metastasis, chest wall, sternum

  15. Lung metastasis of fatty hepatocellular carcinoma after liver transplant: a case report.

    Science.gov (United States)

    Tepeoğlu, Merih; Özdemir, B Handan; Ok Atılgan, Alev; Akdur, Aydıncan; Haberal, Mehmet

    2014-03-01

    Hepatocellular carcinoma with prominent fatty change is rare, and to date only a few cases have been reported. In this article, we present a 57-yearold woman who underwent a liver transplant for hepatocellular carcinoma. Ten months after liver transplant, she presented with a persistent cough. Computed tomography of the chest was performed, revealing a solid lung mass that measured 1 × 0.9 cm in the right inferior lobe. Right inferior lobectomy was performed, and the final diagnosis was noted as hepatocellular carcinoma with prominent fatty change. Fatty change was extensive in the tumor; therefore, lipoid pneumonia was the first condition that was considered in the differential diagnosis during examination of the lobectomy material. For the differential diagnosis, the immunohistochemistry panel was studied to show the hepatocellular nature of the tumor. Although metastasis of hepatocellular carcinoma to the lungs is expected, hepatocellular carcinoma with prominent fatty change can cause diagnostic difficulties, such as lipoid pneumonia, especially in small lung biopsies. PMID:24635803

  16. An Extremely Rare and Unusual Case of Retroperitoneal and Pelvic Metastasis from Squamous Cell Carcinoma of Vallecula

    Directory of Open Access Journals (Sweden)

    Abhishek Purkayastha

    2016-06-01

    Full Text Available We report an extremely rare and unusual case of retroperitoneal and pelvic metastasis from primary squamous cell carcinoma of vallecula. Generally carcinoma oropharynx metastasizes to lungs, liver and bone while retroperitoneal and pelvic metastasis is rarely heard of. To the best of our knowledge this case is one of the scantly reported cases ever of this kind in the world.  A 60-year-old male presented with dysphagia and hoarseness of voice of four month duration.  Computed tomography (CT scan face and neck showed growth right vallecula. Biopsy of lesion showed squamous cell carcinoma. Metastatic work up was negative. He received definitive chemo-radiation. Patient during follow up presented with dyspepsia, abdominal discomfort and weight loss. Whole body positron emission tomography (WB PET scan revealed retroperitoneal and pelvic lymph node deposits which were confirmed as metastasis of squamous cell carcinoma by CT guided fine needle aspiration cytology (FNAC. Patient was exhibited palliative chemotherapy but his general condition deteriorated and he finally succumbed to his metastatic illness. This case is being reported to highlight its extreme rarity, the diagnostic and therapeutic challenges it presented and its overall dismal prognosis.

  17. Radiotherapy for asymptomatic brain metastasis in epidermal growth factor receptor mutant non-small cell lung cancer without prior tyrosine kinase inhibitors treatment: a retrospective clinical study

    International Nuclear Information System (INIS)

    Non-small cell lung cancer (NSCLC) with brain metastasis (BM) harboring an epidermal growth factor receptor (EGFR) mutation shows good response to tyrosine kinase inhibitors (TKIs). This study is to assess the appropriate timing of brain radiotherapy (RT) for asymptomatic BM in EGFR mutant NSCLC patients. There were 628 patients diagnosed with EGFR mutant NSCLC between October 2005 and December 2011. Treatment outcomes had been retrospectively evaluated in 96 patients with asymptomatic BM without prior TKI treatment. 39 patients received first-line brain RT, 23 patients received delayed brain RT, and 34 patients did not receive brain RT. With a median follow-up of 26 months, the 2-year OS was 40.6 %. Univariate analyses revealed that ECOG performance status (p = 0.006), other distant metastases (p = 0.002) and first line systemic treatment (p = 0.032) were significantly associated with overall survival (OS). Multivariate analyses revealed that other sites of distant metastases (p = 0.030) were prognostic factor. The timing of brain RT was not significantly related to OS (p = 0.246). The 2-year BM progression-free survival (PFS) was 26.9 %. Brain RT as first-line therapy failed to demonstrate a significant association with BM PFS (p = 0.643). First-line brain RT failed to improve long-term survival in TKI-naïve EGFR mutant NSCLC patients with asymptomatic BM. Prospective studies are needed to validate these clinical findings

  18. Isolated Asymptomatic Metastasis in the Myocardium: A Rare Scenario in Case of Carcinoma Penis

    OpenAIRE

    Santosh Kumar; Kalpesh Mahesh Parmar; Shivanshu Singh; Jayant Kumar

    2015-01-01

    Penile cancer is a common malignancy in developing countries. It commonly metastasizes to the lymph nodes, lung, liver, and bones. Myocardial metastasis is rare. A 40-year-old male patient presented with ulcerative growth over glans penis. Histologic evaluation of the biopsy sample diagnosed the lesion as squamous cell cancer. Assessment of the stage of the disease revealed cardiac metastasis. Patient received six cycles of chemotherapy. He partially responded, but later succumbed to cardiac ...

  19. Abdominal Wall Metastasis of Uterine Papillary Serous Carcinoma in a Post-Menopausal Woman: A Case Report

    OpenAIRE

    Park, Jung-Woo; Hwang, Sung-Ook

    2014-01-01

    Uterine papillary serous carcinoma (UPSC) is an aggressive form of endometrial cancer characterized by a high recurrence rate and poor prognosis. We report a case of a 58-year-old post-menopausal woman with an abdominal wall metastasis in stage IA UPSC. After surgical staging, she did not receive additional adjuvant therapy. An egg sized palpable mass developed in the right lower abdomen after 8 months. Both Abdominopelvic computed tomography (CT) and positron emission tomography (PET)-CT rev...

  20. Malignant peripheral nerve sheath tumor associated with neurofibromatosis type 1, with metastasis to the heart: a case report

    OpenAIRE

    Araki Nobuhito; Naka Norifumi; Yuki Michiko; Tomoeda Miki; Jin Yu-Fen; Iizuka Norishige; Nagata Shigenori; Wada Naoki; Kitamura Masanori; Yutani Chikao; Tomita Yasuhiko

    2010-01-01

    Abstract A rare case is presented of a 61-year-old man with a malignant peripheral nerve sheath tumor associated with neurofibromatosis type 1, with metastasis to the heart. The primary tumor originated in the right thigh in 1982. Since then, the patient has had repeated local recurrences in spite of repeated surgical treatment and adjuvant chemotherapy. He has developed previous metastases of the lung and heart. The patient died of cardiac involvement.

  1. Malignant peripheral nerve sheath tumor associated with neurofibromatosis type 1, with metastasis to the heart: a case report

    Directory of Open Access Journals (Sweden)

    Araki Nobuhito

    2010-01-01

    Full Text Available Abstract A rare case is presented of a 61-year-old man with a malignant peripheral nerve sheath tumor associated with neurofibromatosis type 1, with metastasis to the heart. The primary tumor originated in the right thigh in 1982. Since then, the patient has had repeated local recurrences in spite of repeated surgical treatment and adjuvant chemotherapy. He has developed previous metastases of the lung and heart. The patient died of cardiac involvement.

  2. A Case of Recurrent Eccrine Porocarcinoma with Regional Lymph Nodal Metastasis, Arising on a Bowen’s Disease Patch

    OpenAIRE

    Thuruthil, Rajesh Reghu; Jayalakshmy, P. S.; Sukumar, Vivek

    2015-01-01

    Eccrine carcinomas are very rare, comprising only less than 0.005 % of all cutaneous carcinomas, as reported by Goellner et al. (Cancer 56:1147–1162, 1985). We are reporting a case of recurrent eccrine porocarcinoma (EPC) with regional lymph nodal metastasis, which arose on a Bowen’s disease patch. Wide local excision of the lesion with lymph node dissection and excision of the Bowen’s disease was done.

  3. Solitary Pancreatic Metastasis from Renal Cell Carcinoma: A Case Report from India with a Review of Literature

    OpenAIRE

    Pankaj Bhalla; Guruprasad Shetty; Chandralekha S Tampi; Prasad K Wagle

    2012-01-01

    Metastatic cancer to the pancreas accounts for less than 2% of all pancreatic malignancies, with renal cell carcinoma being the predominant type. We report the case of an elderly patient detected with a solitary lesion in the head of the pancreas, 6 years after a nephrectomy for renal cell carcinoma. The patient underwent a pancreaticoduodenectomy for the same. A review of literature showed isolated pancreatic metastasis to be rare, ranging from 0.5 to 3%. Patients are usually asymptomatic, u...

  4. Solitary percutaneous transhepatic biliary drainage tract metastasis after curative resection of perihilar cholangiocarcinoma: report of a case

    OpenAIRE

    Hwang, Shin; Jung, Sung-Won; Namgoong, Jung-Man; Yoon, Sam-Youl; Park, Gil-Chun; Jung, Dong-Hwan; Song, Gi-Won; Ha, Tae-Yong; Ko, Gi-Young; Suh, Dong-Wan; Lee, Sung-Gyu

    2011-01-01

    Percutaneous transhepatic biliary drainage (PTBD) has been widely used, but it has a potential risk of tumor spread along the catheter tract. We herein present a case of solitary PTBD tract metastasis after curative resection of perihilar cholangiocarcinoma. Initially, endoscopic nasobiliary drainage was done on a 65 year-old female patient, but the cholangitis did not resolve. Thus a PTBD catheter was inserted into the right posterior duct. Right portal vein embolization was also performed. ...

  5. CT-guide coaxial 125I seeds implantation for the treatment of retroperitoneal lymph node metastasis: analysis of 21 cases

    International Nuclear Information System (INIS)

    Objective: To investigate the method, safety and clinical value of CT-guided coaxial percutaneous 125I seed implantation in treating retroperitoneal metastatic lymph nodes. Methods: CT-guided coaxial percutaneous 125II seed implantation, as interstitial brachytherapy, was carried out in 21 patients with retroperitoneal lymph node metastasis. Before operation therapeutic plan system (TPS) was used in all patients to design the distribution of radioactive particles, and after the procedure CT scanning was performed to verify the distribution of radioactive particles. After the treatment, the abdominal pain, abdominal distension, serum tumor marker levels and local reaction of the target lymph nodes were evaluated. Results: The technical success rate was 100%, and after the operation no serious complications such as gastrointestinal perforation, radiation enteritis, vascular injury, bleeding, etc. occurred. Follow-up CT scanning was conducted once every 1-2 months. Six months after the treatment, complete remission (CR) was obtained in 13 cases, partial remission (PR) in 6 cases, stable disease (SD) in 2 cases, and progression disease (PD) in none. The overall response (CR + PR) rate was 90.5%. The abdominal pain and abdominal distension were relieved in different degrees in 16 patients, and the serum tumor marker levels were decreased in different degrees in 14 patients. Conclusion: For the treatment of retroperitoneal lymph node metastasis, CT-guided coaxial percutaneous l25I seed implantation is effective, safe and reliable. This technique provides a new minimally-invasive treatment for retroperitoneal lymph node metastasis. (authors)

  6. Mandibular metastasis of adenocarcinoma from prostate cancer: case report according to epidemiology and current therapeutical trends of the advanced prostate cancer

    Directory of Open Access Journals (Sweden)

    Juliana Dreyer da Silva de Menezes

    2013-09-01

    Full Text Available Prostate cancer represents the most frequent non-cutaneous neoplasia in males. This type of neoplasia can develop peculiar patterns of evolution, presenting, in many cases, precocious relapses and metastasis. Bone metastasis in the mouth is extremely rare, and represents 1% of all malignant mouth neoplasias. The aim of the present study is to report a clinical case of bone metastasis in the mandibular region associated with a tumoral prostate adenocarcinoma, as well as to discuss connected aspects about diagnosis, prognosis and integrated treatment of this condition.

  7. Cavitary pulmonar metastasis

    International Nuclear Information System (INIS)

    Seven cases of cavitary lung metastasis, four from head and neck neoplasma, two from uterine carcinoma and one from hepatoma are reported. The physiopathology and the most common sites of this kind of lesion are discussed. The rarity of the solitary excavated metastasis from hepatoma, not reported previously in the literature reviewed, is emphasized. (Author)

  8. Carcinoma of uterine cervix with isolated metastasis to fibula and its unusual behavior: Report of a case and review of literature

    Directory of Open Access Journals (Sweden)

    Pasricha Rajesh

    2006-01-01

    Full Text Available Bone metastasis from carcinoma cervix is uncommon, especially in the distal appendicular skeleton. A 36 year old lady presented with carcinoma of uterine cervix, FIGO, stage IIb. She was treated with radical radiotherapy. Nine months later, she developed an isolated lytic lesion in right fibula, which turned out to be a metastatic lesion. The patient is doing well, 3 years after the surgical excision of metastasis. This is one of the few documented cases of metastasis to fibula, arising from carcinoma of uterine cervix and probably the first with isolated metastasis of this site. Unlike the dismal outcome commonly seen in patients with bone secondaries, she continues to be disease free and alive at 39 months of follow up, after the development of skeletal metastasis.

  9. Gastrointestinal tract metastasis from tubulolobular carcinoma of the breast: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Wang GX

    2014-03-01

    Full Text Available Guixin Wang, Tingjiang Wang, Jian Jiang, Luyao Zhou, Haidong Zhao Department of Breast Surgery, The Second Affiliated Hospital of Dalian Medical University, Shahekou District, Dalian, Liaoning Province, People's Republic of China Abstract: Metastasis of breast cancer into the gastrointestinal tract happens rarely. The diagnosis of this kind of disease is difficult because of the nonspecific symptoms and the long interval between primary manifestations and recurrence. Awareness of this condition may lead to an accurate diagnosis and an earlier initiation of systemic treatment, thus avoiding unnecessary surgical intervention. In this paper, we report a rare case of a patient with tubulolobular carcinoma metastases to the colon, presenting with abdominal pain, discomfort, and weight loss. The patient underwent radical mastectomy and received postoperative radiotherapy and chemotherapy. Ten years later, she presented with gastrointestinal tract symptoms. Surgery combined with systemic treatment was chosen for the colon lesion. Immunohistochemical staining suggested a breast origin. The patient was still living 24 months after the diagnosis of the metastasis. This is the fourth case report in our literature review. Keywords: breast cancer, tubulolobular carcinoma, metastasis, gastrointestinal tract

  10. Brain drain or brain gain: The case of Suriname

    OpenAIRE

    Dulam, Tina

    2015-01-01

    markdownabstractAbstract Brain drain refers to the emigration of highly skilled individuals mostly from a less developed (home) to a developed country (destination) thereby reducing the capacity of the home country to generate welfare for its population. In the literature there is much written about this phenomenon, but there is a new theory, entitled brain gain. This theory suggests that the prospect of emigrating and earning higher income when being highly educated encourages the remaining ...

  11. A Case of Urethral Metastasis from Sigmoid Colon Cancer Diagnostically and Prognostically Indicated by F 18 FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Han Seok; Kim, Eun Sil; Kim, Soyon; Im, Su Jin; Park, Yong Hyun; Lee, Ju Hyoung; Hur, So Chong [National Police Hospital, Seoul (Korea, Republic of)

    2011-12-15

    Urethral metastasis from colorectal cancer is rare and is known to have a poor prognosis. A 72 year old man with a history of colectomy and colostomy due to sigmoid colon cancer was admitted to the emergency room with bowel distension, rectal bleeding and urinary symptoms. Computed tomography of the abdominopelvis showed sigmoid colon cancer with multiple metastases involving the liver. Positron emission tomography with F 18 fluorodeoxyglucose (FDG) showed multiple hypermetabolic foci in the liver, penis and pubic bone, which otherwise could not be diagnosed. The lesions revealed no improvement with chemotherapy and urological surgery on follow up F 18 FDG PET/CT. We present a case of urethral metastasis of sigmoid colon cancer diagnostically and prognostically indicated by F 18 FDG PET/CT.

  12. Metastasis of Ciliary Body Melanoma to the Contralateral Eye: A Case Report and Review of Uveal Melanoma Literature

    Directory of Open Access Journals (Sweden)

    Nouritza M. Torossian

    2015-01-01

    Full Text Available Many types of cancers metastasize to the eye. However, uveal melanoma metastasizing to the contralateral choroid is very rare. We report the case of a 68-year-old man with history of treated uveal melanoma of the right eye that developed metastasis to the liver and the choroid of the left eye. Ten years earlier, he was diagnosed to have uveal melanoma of the right eye and was initially treated with plaque radiotherapy. Two years later, upon progression of the disease in the right eye he had enucleation of the eye. We describe the patient’s clinical history, the diagnosis of recurrent disease in the contralateral eye, therapy of the left eye, and systemic metastasis. In addition, we reviewed the published medical literature and described the recent advances in the management of uveal melanoma.

  13. Pancreatic metastasis in a case of small cell lung carcinoma: Diagnostic role of fine-needle aspiration cytology and immunocytochemistry

    Directory of Open Access Journals (Sweden)

    Dilip K Das

    2011-01-01

    Full Text Available Small cell lung carcinoma represents a group of highly malignant tumors giving rise to early and widespread metastasis at the time of diagnosis. However, the pancreas is a relatively infrequent site of metastasis by this neoplasm, and there are only occasional reports on its fine needle aspiration (FNA cytology diagnosis. A 66-year-old man presented with extensive mediastinal lymphadenopathy and a mass in the pancreatic tail. Ultrasound-guided FNA smears from the pancreatic mass contained small, round tumor cells with extensive nuclear molding. The cytodiagnosis was metastatic small cell carcinoma. Immunocytochemical staining showed that a variable number of neoplastic cell were positive for cytokeratin, chromogranin A, neurone-specific enolase and synaptophysin but negative for leukocyte common antigen. The trans-bronchial needle aspiration was non-diagnostic, but biopsy was suspicious of a small cell carcinoma. This case represents a rare metastatic lesion in the pancreas from small cell lung carcinoma, diagnosed by FNA cytology.

  14. Minute gastric carcinoid tumor with regional lymph node metastasis:A case report and review of literature

    Institute of Scientific and Technical Information of China (English)

    Sbu-Duo Xie; Lin-Bo Wang; Xiang-Yang Song; Tao Pan

    2004-01-01

    We have encountered an unusual case of gastric carcinoid tumor. Gastroscopic examination of this 32-year-old male patient showed a smooth protrusion at the greater curvature of the gastric body with a central depression,identified by subsequent biopsy as carcinoma. The patient had a normal serum gastrin level and was negative for anti-parietal cell antibody. Histological examination of the resected gastric tissues showed that the tumor was a carcinoid, 0.3 cm×0.3 cm in size with only one regional lymph node metastasis. We reviewed the pathogenesis,clinical presentation, diagnosis and treatment of gastric carcinoids and raise the possibility of being a lymph vesselrelated metastasis even for a minute carcinoid tumor.Sentinel lymph node biopsy is recommended for surgery of minute carcinoid tumors.

  15. Computed tomographic evaluation of intracranial metastasis

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Jin Kyo; Eun, Chung Kie; Kim, Soon Yong [Kyung Hee University Hospital, Seoul (Korea, Republic of)

    1982-09-15

    Computed tomography was proved to be the most accurate diagnostic tool in the analysis of brain metastasis than any other classical methods. The authors studied CT findings of intracranial metastasis in 31 cases proven clinically and histologically. The results were as follows: 1. Age distribution of the cases was 15 males and 16 females with peak age of 6th decade in males and 4th decade in female. 2. Metastic lesions were multiple in 18 cases and single in 13 cases. 3. The most common degree of edema was grade III, 43% of total metastatic foci. Marked edematous low densities with relatively small nodular high densities in precontrast scan and variable contrast enhancement of the nodular densities were the most frequent CT findings. 4. No specific characteristics according to the primary cancer was noted. All four cases of choriocarcinoma showed hemorrhagic tendency.

  16. Radiosurgical treatment of previously irradiated primary brain tumors and brain metastasis: final report of radiation therapy oncology group (RTOG) protocol 90-05

    International Nuclear Information System (INIS)

    Purpose/Objective: To determine the maximum single radiosurgical dose that can be given to patients (pts) with recurrent primary brain tumors (1 deg. BT) or brain metastasis (BM) who had received prior fractionated external beam radiation therapy (FEBRT). Materials/Methods: The treated tumor had to be ≤40 mm in maximum diameter. Dose was prescribed to the periphery of the tumor (without margin) based on diameter, to the 50% to 90% isodose line. Initial doses were: Arm 1--≤20 mm, 18 Gy; Arm 2--21 to 30 mm, 15 Gy; and Arm 3--31 to 40 mm, 12 Gy. Dose was then escalated in 3 Gy increments, providing that unacceptable neurologic toxicity (grade 3,4, or 5 using the RTOG Central Nervous System (CNS) Toxicity Criteria) occurred in 3, 5977 mm3, and 18,202 mm3 for tumors ≤20 mm, 21-30 mm, and 31-40 mm in maximum diameter, respectively. Thirty-one pts were treated on a Gamma Knife and 125 on a linear accelerator. The table below summarizes the toxicity results of the study: Analysis of variables contributing to toxicity demonstrated that tumors with a maximum diameter of 21-40 mm had a 1.2 times greater chance of developing unacceptable neurologic toxicity than tumors ≤20 mm in diameter. Local failure (in the radiosurgical treatment volume) occurred in 37 pts (24%). The most significant variable contributing to local failure was tumor type. 1 deg. BT were twice as likely to develop local failure than BM. Twenty-one pts (14%) underwent reoperation. Pathologic findings were as follows: tumor only--38%, tumor + necrosis--33%, necrosis only--19%, and non-diagnostic--10%. Conclusions: In previously irradiated patients with recurrent 1 deg. BT and BM, the maximum safe dose of single fraction radiosurgery was 24 Gy for tumors ≤20 mm in maximum diameter, 21 Gy for 21-30 mm tumors, and 15 Gy for tumors 31-40 mm

  17. Comparison of FDG-PET findings of brain metastasis from non-small-cell lung cancer and small-cell lung cancer

    International Nuclear Information System (INIS)

    We compared the F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) findings of brain metastasis between patients with non-small-cell lung cancer (NSCLC) and small cell lung cancer (SCLC). A whole-body FDG and a brain PET were performed in 48 patients (31 men, 17 women; 57±9 years, 42 NSCLC, 6 SCLC), who had brain metastasis on magnetic resonance (MR). All primary lung lesions were detected by FDG-PET and confirmed pathologically. We analyzed the PET findings, lesion sizes, and the pathological result of primary lung cancer. Of the 48 patients, 31 (64.6%) showed hypermetabolic lesions on FDG-PET of the brain image, and 14 (29.2%) showed hypometabolic lesions. Three patients (6.3%) had both hypermetabolic and hypometabolic lesions. On the lesion-based analysis, 74 lesions (67.3%) showed hypermetabolism on FDG-PET, and 36 lesions (32.7%) showed hypometabolism. All primary lung lesions were hypermetabolic on FDG-PET. When the FDG findings of metastatic brain lesions were analyzed with the pathological types of primary lung cancer, NSCLC was more frequently associated with hypermetabolic metastatic brain lesions than SCLC (80% and 26.7%, respectively, P<0.01). On comparing the sizes of metastatic lesions between SCLC (1.3±1.2 cm) and NSCLC (1.8±1.2 cm), lesions of <1 cm were more frequent in SCLC than in NSCLC (P=0.012). But no significant relationship was found between the size and PET finding of metastatic lesion (P=0.412). Even when the primary lesion of lung cancer showed hypermetabolism in FDG-PET, FDG accumulation in metastatic brain lesions was variable. One-third of brain metastases from lung cancer showed hypometabolism. NSCLC was more frequently associated with hypermetabolic metastatic brain lesions than SCLC. The PET findings of brain lesions were affected not only by the size of lesion but also by its biological characteristics. (author)

  18. Isolated Asymptomatic Metastasis in the Myocardium: A Rare Scenario in Case of Carcinoma Penis

    Directory of Open Access Journals (Sweden)

    Santosh Kumar

    2015-01-01

    Full Text Available Penile cancer is a common malignancy in developing countries. It commonly metastasizes to the lymph nodes, lung, liver, and bones. Myocardial metastasis is rare. A 40-year-old male patient presented with ulcerative growth over glans penis. Histologic evaluation of the biopsy sample diagnosed the lesion as squamous cell cancer. Assessment of the stage of the disease revealed cardiac metastasis. Patient received six cycles of chemotherapy. He partially responded, but later succumbed to cardiac failure due to pericardial and pleural effusion.

  19. Radiation-induced brain injury: retrospective analysis of twelve pathologically proven cases

    International Nuclear Information System (INIS)

    This study was designed to determine the influencing factors and clinical course of pathologically proven cases of radiation-induced brain injury (RIBI). The pathologic records of twelve patients were reviewed; these patients underwent surgery following radiotherapy due to disease progression found by follow-up imaging. However, they were finally diagnosed with RIBI. All patients had been treated with 3-dimensional conventional fractionated radiotherapy and/or radiosurgery for primary or metastatic brain tumors with or without chemotherapy. The histological distribution was as follows: two falx meningioma, six glioblastoma multiform (GBM), two anaplastic oligodendroglioma, one low grade oligodendroglioma, and one small cell lung cancer with brain metastasis. Radiation necrosis was noted in eight patients and the remaining four were diagnosed with radiation change. Gender (p 0.061) and biologically equivalent dose (BED)3 (p = 0.084) were the only marginally influencing factors of radiation necrosis. Median time to RIBI was 7.3 months (range, 0.5 to 61 months). Three prolonged survivors with GBM were observed. In the subgroup analysis of high grade gliomas, RIBI that developed <6 months after radiotherapy was associated with inferior overall survival rates compared to cases of RIBI that occurred ≥6 months (p = 0.085). Our study demonstrated that RIBI could occur in early periods after conventional fractionated brain radiotherapy within normal tolerable dose ranges. Studies with a larger number of patients are required to identify the strong influencing factors for RIBI development

  20. Cerebral metastasis from malignant pleural mesothelioma

    Science.gov (United States)

    El Molla, Mohamed; Gragnaniello, Cristian; Al-Khawaja, Darweesh; Chiribao-Negri, Concepcion; Eftekhar, Behzad

    2013-01-01

    Malignant mesothelioma is an uncommon, highly invasive tumor derived from the mesothelial cells of pleura or peritoneum characterized by poor outcome. Mesothelioma was thought to metastasize locally only via direct invasion and not have distant spread. Distant metastases were discovered mostly on post-mortem examination. The authors present a case of 62-year-old man with pleural mesothelioma and brain metastasis. PMID:24963909

  1. Axillary Metastasis in the Abdominal Dermatofibrosarcoma Protuberans with the Fibrosarcomatous Changes: A Case Report

    International Nuclear Information System (INIS)

    Most distant metastases of dermatofibrosarcoma protuberans (DFSP) occurs with the repeated local recurrences and mainly in the lungs. Focusing on the imaging features, we report a unique occurrence of the distant metastasis of DFSP with fibrosarcomatous changes to the axillary soft tissue without previous local recurrences, possibly misdiagnosed as the accessory breast cancer.

  2. Axillary Metastasis in the Abdominal Dermatofibrosarcoma Protuberans with the Fibrosarcomatous Changes: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, So Jung; Jung, Hae Kyoung; Kim, Kwang Il [CHA Bundang Medical Center, CHA University, Seongnam (Korea, Republic of)

    2013-03-15

    Most distant metastases of dermatofibrosarcoma protuberans (DFSP) occurs with the repeated local recurrences and mainly in the lungs. Focusing on the imaging features, we report a unique occurrence of the distant metastasis of DFSP with fibrosarcomatous changes to the axillary soft tissue without previous local recurrences, possibly misdiagnosed as the accessory breast cancer.

  3. Unusual case of hepatic metastasis in follicular thyroid carcinoma detected using I-131 whole body scintigraphy and single-photon emission computerized tomography/computerized tomography

    International Nuclear Information System (INIS)

    Papillary and follicular thyroid carcinomas, together known as differentiated thyroid carcinomas (DTC), are among the most curable of cancers. Distant metastases are rare events at the onset of DTC. Among these presentations, metastasis to the liver is even more unusual. Only 11 cases of DTC with liver metastasis were previously reported in the literature. We present a 55-year-old male on Iodine-131 whole body scintigraphy showed intense uptake in thyroid bed, metastasis in both lungs and right lobe of the liver. Radioiodine concentration in liver metastases made him amenable to high-dose radioiodine therapy patient

  4. Brain drain or brain gain : The case of Suriname

    NARCIS (Netherlands)

    T.W. Dulam (Tina)

    2015-01-01

    markdownabstractAbstract Brain drain refers to the emigration of highly skilled individuals mostly from a less developed (home) to a developed country (destination) thereby reducing the capacity of the home country to generate welfare for its population. In the literature there is much written ab

  5. Two unusual cases of brain metastases from lung primary malignant melanoma

    International Nuclear Information System (INIS)

    Start with two cases of brain metastases from lung melanoma are presented who were diagnosed in the Neuropathology Laboratory of the Department of Anatomy Pathology, Institute of Neurology, Hospital de Clinicas, Montevideo, emphasizing the pathological diagnostic criteria and their evolution clinic. Both patients presented at the time of the initial consultation injuries amelánica respectively pigmented single brain. In both cases ruled by the morphology and the use of complementary techniques metastasis carcinoma. The main differential diagnosis of these lesions is whether is a primitive brain tumor, pigmented or not, or of a secondary tumor melanin: metastatic malignant melanoma. In both cases the patients had been studied one being in an unresectable lung injury, and in the other showed a single pulmonary nodule was resected in its entirety. the pulmonary lesions were for malignant melanoma, one with ample pigment and the other for the most part amelánico, with few areas retained pigment. He studied dermatologist, discarded the presence of a cutaneous malignant melanoma primitive. Other locations were also excluded

  6. Increased survival with the combination of stereotactic radiosurgery and gefitinib for non-small cell lung cancer brain metastasis patients: a nationwide study in Taiwan

    International Nuclear Information System (INIS)

    Whole brain irradiation (WBRT) either with or without resection has historically been the treatment for brain metastases from non-small cell lung cancer (NSCLC). The effect of gamma knife (GK) radiosurgery, chemotherapy, or the combination remains incompletely defined. In this study, we assessed the outcome of brain metastases from non-small cell lung cancer treated by WBRT followed by GK, gefitinib, or the combination of GK and gefitinib. We retrieved the records of NSCLC patients with brain metastases from the National Health Insurance Research Database (NHIRD) of Taiwan from 2004 to 2010. WBRT either with or without resection was the first line treatment for nearly all patients. The decision to add GK and/or gefitinib treatment was at the discretion of the treating physician and based upon a patient’s medical records and imaging data. These patients were classified into four groups including WBRT, WBRT + gefitinib, WBRT + GK, WBRT + gefitinib + GK. These data was evaluated for difference in survival and factors that portended an extended survival from the time of brain metastasis diagnosis. Of the 60194 patients with newly diagnosed NSCLC, 23874 (39.6 %) developed brain metastases. The distribution of patients for the groups was WBRT for 20241, WBRT + gefitinib for 3379, WBRT + GK for 155, and WBRT+ gefitinib + GK for 99 patients. The median survival for the time of brain metastasis diagnosis for WBRT, WBRT+ gefitinib, WBRT+ GK, WBRT+ gefitinib + GK groups was 0.53, 1.01, 1.46, and 2.25 years, respectively (p < 0.0001). The hazard ratio (95 % CI) for survival was 1, 0.56, 0.43, and 0.40, respectively (p < 0.001). The adjusted hazard ratio (95 % CI) by age, sex and Charlson comorbidity index (CCI) was 1, 0.73, 0.49, and 0.42, respectively (p < 0.001). Patients with brain metastases from NSCLC receiving GK or gefitinib demonstrated extended survival. The improved survival seen with GK and gefitinib suggests a survival benefit in selected patients receiving the

  7. Pharmacologic inhibition of MLK3 kinase activity blocks the in vitro migratory capacity of breast cancer cells but has no effect on breast cancer brain metastasis in a mouse xenograft model.

    Directory of Open Access Journals (Sweden)

    Kun Hyoe Rhoo

    Full Text Available Brain metastasis of breast cancer is an important clinical problem, with few therapeutic options and a poor prognosis. Recent data have implicated mixed lineage kinase 3 (MLK3 in controlling the in vitro migratory capacity of breast cancer cells, as well as the metastasis of MDA-MB-231 breast cancer cells from the mammary fat pad to distant lymph nodes in a mouse xenograft model. We therefore set out to test whether MLK3 plays a role in brain metastasis of breast cancer cells. To address this question, we used a novel, brain penetrant, MLK3 inhibitor, URMC099. URMC099 efficiently inhibited the migration of breast cancer cells in an in vitro cell monolayer wounding assay, and an in vitro transwell migration assay, but had no effect on in vitro cell growth. We also tested the effect of URMC099 on tumor formation in a mouse xenograft model of breast cancer brain metastasis. This analysis showed that URMC099 had no effect on the either the frequency or size of breast cancer brain metastases. We conclude that pharmacologic inhibition of MLK3 by URMC099 can reduce the in vitro migratory capacity of breast cancer cells, but that it has no effect on either the frequency or size of breast cancer brain metastases, in a mouse xenograft model.

  8. The Clinical Value of Axillary Ultrasonogra- phy for Detection of Axillary Lymph Node Metastasis in Cases with Breast Cancer

    Directory of Open Access Journals (Sweden)

    Sedigheh Tahmasebi

    2014-10-01

    Full Text Available Background: The axillary lymph node stage is one of the single most important determinants in the prognosis of breast cancer patients. The disadvantages of the two previous methods used for evaluating axillary node metastasis, i.e., axillary lymph node dissection and sentinel lymph node biopsy, have directed researchers to investigate new techniques for this purpose. The aim of the current study was to evaluate the clinical usefulness of axillary ultrasonography in detecting axillary metastasis. Methods: This study was conducted during a 12-month period. The breast cancer cases included in this study were all clinically diagnosed as stages I and II, with no prior treatment to the axillary region by surgery and/or chemo-radiotherapy. Excluded from the study group were patients with palpable axillary lymph nodes, those who had major organ failure or concomitant malignancy. All included patients with non-palpable axillary lymph nodes underwent axillary ultrasound examination. An ultrasound- guided core needle biopsy was performed on patients with suspected metastasis. Results: There were 125 female patients with a mean age of 49.6 years included in this study. From these, 16 (12.8% cases had positive axillary sonographic findings. Pathologic evaluation of tissue specimens (taken by ultrasound-guided core needle biopsy in 10 (62.5% out of 16 patients were positive, and in the patient group of 6 (37.5% cases, studies were negative. Axillary ultrasonography had a sensitivity of 35.7%, specificity of 93.8%, positive predictive value of 62.5%, and negative predictive value of 83.5%. Conclusion: The axillary ultrasonogram is a reliable technique in the determination of axillary nodal metastatic involvement in breast cancer patients. By use of this method a significant amount of complications and costs related to the previous techniques can be avoided.

  9. Radically treated carcinoma lung with early metastasis to the tongue: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Alagu Ganesh

    2014-01-01

    Full Text Available Metastatic lesions to the oral cavity are rare and constitute 1% of all oral lesions. Soft tissues in the oral cavity are less commonly affected when compared with bone. In males, lung is the most common primary site, and the overall survival is low. We present a case of sarcomatoid carcinoma (spindle cell carcinoma of lung that developed metastasis to the tongue alone soon after completing radical treatment. Immunohistochemistry plays a major role in differentiating a primary tongue lesion from a metastatic lesion.

  10. Tageted bipolar radiofrequency decompression with vertebroplasty for intractable radicular pain due to spinal metastasis: a case report

    Science.gov (United States)

    Baek, Seong Jin; Lee, Eun Young

    2016-01-01

    Metastatic spinal tumors are usually quite difficult to treat. In patients with metastatic spinal tumors, conventional radiotherapy fails to relieve pain in 20–30% of cases and open surgery often causes considerable trauma and complications, which delays treatment of the primary disease. Percutaneous vertebroplasty (PVP) is considered to be useful in achieving rapid pain control and preventing further vertebral collapse due to spinal metastasis. However, symptoms of intraspinal neural compression can be contraindications to PVP. To overcome this problem, we performed PVP following targeted bipolar radiofrequency decompression, and examined the effect of the combined treatment in relieving severe radicular pain related to spinal cord compression caused by malignant metastatic tumors. PMID:27482319

  11. Unusual case of Hodgkin lymphoma presenting as soft tissue mass with intracranial metastasis and review of literature

    Directory of Open Access Journals (Sweden)

    Vandana Singh Kushwaha

    2015-01-01

    Full Text Available Hodgkin lymphoma (HL primarily presents as nodal disease and may involve extranodal sites during the progression of the disease. Extra nodal involvement of lung, gastrointestinal tract, testis and thyroid etc., is well-recognized in non-HL but clinically detectable soft tissue involvement is rare and quite exceptional with HL. We report here an unusual case of a young adult male, who presented with a frontal soft tissue mass associated with cervical lymph node. Histopathology supplemented with immunohistochemistry revealed classical HL. Patient did not respond to treatment adequately, and he developed intracranial metastasis during the course of treatment.

  12. Cystic Pulmonary Metastasis in a Patient with Scalp Angiosarcoma: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ah Yeong; Lee, Kyung Soo; Han, Jong Ho; Kim, Ho Joong; Kim, Kwhan Mien; Baek, Chung Hwan [Samsugn Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2011-08-15

    It has been well known that angiosarcoma (AS), particularly scalp AS, metastasizes to the lungs with multiple air-filled cystic lesions on chest computed tomography scans. Pneumothorax, due to cystic lesion rupture into the pleural space, is frequent;however, we do not exactly know how rapidly the metastatic lesions spread to the lungs or what the exact pathogenetic mechanism for cystic metastasis is. According to our experience, the speed of disease progression in pulmonary metastasis is relatively fast and the entire lungs may be involved within two or three months. The infiltrating spindle cell tumors in the alveolar walls are tethering the adjacent alveolar spaces in order to form a dilated air-filled cystic lesion.

  13. Abscess mimicking lung metastasis in a 10-year-old boy – case report

    International Nuclear Information System (INIS)

    Malignant pulmonary tumours in children are very rare; the majority are metastases. Nonspecific radiographic findings of these abnormalities are challenging and may delay the final diagnosis and treatment. A 10-year-old boy was admitted to our hospital because of the clinical and radiographic symptoms and signs of pneumonia with abscess formation in the left lower lobe. After initial improvement on antibiotic therapy, a significant deterioration of the patient’s condition was observed, together with progression in radiographic examinations. The patient was treated surgically and transferred to the Haematology and Oncology Department with a final diagnosis of pulmonary metastasis of clear cell sarcoma. Radiographic findings of metastatic diseases may mimic non-neoplastic pulmonary conditions. A lack of specific clinical symptoms and a confusing radiographic pattern in our patient with clear cell sarcoma lung metastasis caused serious diagnostic difficulties

  14. Adaptive hypofractionated gamma knife radiosurgery for a large brainstem metastasis

    OpenAIRE

    Georges Sinclair; Jiri Bartek; Heather Martin; Pierre Barsoum; Ernest Dodoo

    2016-01-01

    Background: To demonstrate how adaptive hypofractionated radiosurgery by gamma knife (GK) can be successfully utilized to treat a large brainstem metastasis - a novel approach to a challenging clinical situation. Case Description: A 42-year-old woman, diagnosed with metastatic nonsmall cell lung cancer in July 2011, initially treated with chemotherapy and tyrosine kinase inhibitors, developed multiple brain metastases March 2013, with subsequent whole brain radiotherapy , after which a ma...

  15. Primary hyperaldostronisim as initial presentation of adrenal cortical carcinoma with liver metastasis: a case report.

    Science.gov (United States)

    Aghamohammadzadeh, Naser; Faraji, Afsaneh; Bozorgi, Farshid; Faraji, Ismail; Moghadaszadeh, Majid

    2013-01-01

    Adrenocortical carcinoma (ACC) is a rare tumor and usually a fatal disease which can develop at any age in either sex. Differential diagnosis between malignant and benign adrenal mass is not easy which leads to significant clinical challenge for optimal treatment. Here we report a 22-year-old woman diagnosed with primary hyper aldostronism initially but disease relapsed during six months and magnetic resonance imaging revealed tumor with metastasis to the liver. PMID:24505527

  16. Primary Hyperaldostronisim as Initial Presentation of Adrenal Cortical Carcinoma with Liver Metastasis: A Case Report

    OpenAIRE

    Aghamohammadzadeh, Naser; Faraji, Afsaneh; Bozorgi, Farshid; Faraji, Ismail; Moghadaszadeh, Majid

    2013-01-01

    Adrenocortical carcinoma (ACC) is a rare tumor and usually a fatal disease which can develop at any age in either sex. Differential diagnosis between malignant and benign adrenal mass is not easy which leads to significant clinical challenge for optimal treatment. Here we report a 22-year-old woman diagnosed with primary hyper aldostronism initially but disease relapsed during six months and magnetic resonance imaging revealed tumor with metastasis to the liver.

  17. Cases of Renal Cell Carcinoma and Lung Metastasis Sequential Bilateral Pneumothorax

    OpenAIRE

    Mahmut Tokur

    2013-01-01

    The metastasis of the lungs develop in proportion as 30% of all cancers. Spontaneous pneumothorax is a rarely found but clinically significant complication in lung and trachea tumors. Spontaneous pneumothorax may also occur in metastatic tumors. Different levels of dispnea are observed in metastatic lung tumors according to the prevalance of the lesions. Sudden or progressive incline in the shortness of breath in these patients may be the harbinger of a spontaneous pneumothorax. In this prese...

  18. Melanotic Schwannoma of the Cervical Spine Progressing With Pulmonary Metastasis: Case Report

    OpenAIRE

    Faria, Mário Henrique Girão; Dória-Netto, Ricardo Henrique; Osugue, Gustavo Jun; Queiroz, Luciano Souza; Chaddad-Neto, Feres Eduardo

    2013-01-01

    Melanotic schwannoma (MS) is an unusual variant of nerve sheath neoplasm. Only 10% of these tumors will undergo malignant degeneration, with exceedingly rare reported metastasis. We present a 32-year-old woman with a 6-month history of cervical pain and left arm progressive weakness. Neurological examination showed a left upper limb radicular pain, with pyramidal syndrome at C5 level. The magnetic resonance imaging (MRI) study highlighted an intradural extramedullary heterogeneous mass along ...

  19. Metastatic hepatocellular carcinoma of the maxillary sinus: a rare autopsy case without lung metastasis and a review.

    Science.gov (United States)

    Okada, H; Kamino, Y; Shimo, M; Kitamura, E; Katoh, T; Nishimura, H; Akimoto, Y; Kaneda, T; Hinata, M; Yamamoto, H

    2003-02-01

    A rare case of metastatic hepatocellular carcinoma (HCC) of the maxillary sinus in a 67-year-old man is reported along with the findings at autopsy. A fine needle aspiration biopsy specimen revealed a characteristic tumour structure resembling primary HCC. At autopsy, metastatic lesions were recognized in the bilateral adrenals, spleen, sternum, vertebrae and lymph node at the lesser curvature of the stomach, but not in the lung, suggesting that the HCC had metastasized to the maxillary sinus via the plexus venous vertebralis and/or the azygos vein, or lymph duct. In our reviewed 29 cases of metastatic HCC in the oro-maxillofacial region, most patients were men in the 50- to 70-year age range. At least 11 cases did not have lung metastasis, and in 18, metastasis to the oro-maxillofacial region was the first sign of HCC. One should be aware of the possibility to encounter the oral lesion as first sign of metastatic HCC. PMID:12653243

  20. A case report of hepatectomy for liver metastasis of colon cancer after heavy particle radiotherapy

    International Nuclear Information System (INIS)

    A 51-year-old female patient was admitted to our hospital with a diagnosis of sigmoid colon cancer, and a sigmoidectomy and D3 lymphadenectomy was performed. The tumor was a moderately differentiated tubular adenocarcinoma (pT3N0M0, pStage 2). No adjuvant therapy was administered. An abdominal computed tomography (CT) performed 11 months after the sigmoidectomy revealed a hepatic metastasis. The patient chose to undergo carbon ion radiotherapy (53.0 GyE/1 Fr). However, a second CT performed 10 months later indicated regrowth of the hepatic metastasis. A partial liver resection was performed, and severe deformity was observed in the irradiated region of the liver. The borderline between the tumor and surrounding tissue was not clearly discriminated. Histopathological examinations indicated increased numbers of fibrous cells in the irradiated region. To perform hepatic resection safely for liver metastasis of colorectal cancer following heavy particle radiotherapy, it is necessary to accurately determine the resection line before and during surgery. When feasible, resection of the whole irradiated area should be considered. (author)

  1. Unusual splenic metastasis from oesophageal cancer.

    OpenAIRE

    Murthy S; Prabhakaran P; Rao S; Kumar R

    1991-01-01

    The most common visceral metastasis from oesophageal carcinomas are lungs and liver. A case of splenic metastasis from a squamous carcinoma of oesophagus is reported. To our knowledge, splenic metastasis without any nodal disease has not been described previously. The pattern of reported metastasis is summarised.

  2. 转移性乳腺癌出现脑转移相关危险因素分析%Analysis of the risk factors for brain metastasis among patients with metastatic breast cancer

    Institute of Scientific and Technical Information of China (English)

    李瑞霞; 魏素菊

    2013-01-01

    Objective This study aimed at retrospective analysis of some metastatic breast cancer cases,investigated the recurrence of brain metastases of metastatic breast cancer in patients with risk factors,and provided a reference for the implementation of prevention strategies in the treatment plan and a reasonable choice.Methods A total of 796 breast cancer cases was visited,of whom 456 patients with recurrent metastatic breast cancer,in which 61 patients were with brain metastasis.The follow-up data were analyzed with SPSS13.0 software.x2 was used to test the age,estrogen receptor (ER),progesterone receptor (PR),cerbB-2 expression,lymph node metastasis,and brain metastasis.The COX proportional hazard model was used to analyze the recurrence and metastasis in patients with single-factor,multi-factor analysis,in order to obtain the independent prognostic factors.Results The x2 tests that group age ≤ 35 years,hormone receptor-negative,CerbB-2 (2 +)/(3 +) has a higher risk than another group (x2 =24.92,8.28,4.02,P <0.01 orP <0.05).COX univariate analysis showed that patient age,tumor size,ER and PR expression,CerbB-2 expression,lung metastases were looked.as the first metastatic site and hormone therapy.Those were significant factors whether the patient suffered from brain metastasis (P < 0.05).COX multivariate analysis showed that age,ER and PR expression,CerbB-2 expression,and lung metastases were looked as the first metastatic site acted as an independent prognostic factor for brain metastasis (P <0.05).Conclusions Age,ER and PR expression,CerbB-2 expression,lung metastases as the first metastatic site are the independent prognostic factors for brain metastasis.%目的 对转移性乳腺癌病例进行回顾性分析,探讨其再发生脑转移的危险因素,以便于预防策略的实施和合理治疗计划的选择.方法 随访的796例乳腺癌患者中有456例出现转移,其中再出现脑转移者61例.将随访资料录入SPSS 13.0软

  3. Confounding factors in diagnosing brain death: a case report

    Directory of Open Access Journals (Sweden)

    Login Ivan S

    2002-06-01

    Full Text Available Abstract Background Brain death is strictly defined medically and legally. This diagnosis depends on three cardinal neurological features: coma, absent brainstem reflexes, and apnea. The diagnosis can only be made, however, in the absence of intoxication, hypothermia, or certain medical illnesses. Case presentation A patient with severe hypoxic-ischemic brain injury met the three cardinal neurological features of brain death but concurrent profound hypothyroidism precluded the diagnosis. Our clinical and ethical decisions were further challenged by another facet of this complex case. Although her brain damage indicated a hopeless prognosis, we could not discontinue care based on futility because the only known surrogate was mentally retarded and unable to participate in medical planning. Conclusion The presence of certain medical conditions prohibits a diagnosis of brain death, which is a medicolegal diagnosis of death, not a prediction or forecast of future outcome. While prognostication is important in deciding to withdraw care, it is not a component in diagnosing brain death.

  4. 1 case of skeletal muscle metastasis after resection of rectal cancer%直肠癌术后横纹肌转移1例

    Institute of Scientific and Technical Information of China (English)

    刘昌胜; 孙茂松

    2015-01-01

    After resection of rectal cancer,the tumor is more prone to transfer,the main way of transfer are the direct spread, lymph node metastasis,blood and plant metastasis and so on.Skeletal muscle metastasis of rectal cancer is rare in clinic.In this paper,the author briefly introduces the 1 case of skeletal muscle metastasis after resection of rectal cancer,to provide discuss for the clinical.%目的:直肠癌术后较易发生转移,其转移的途径主要有直接蔓延、淋巴转移、血运和种植转移等.直肠癌的骨骼肌转移临床上非常罕见,本文简要介绍直肠癌术后横纹肌转移1例,为临床提供探讨.

  5. Mucinous carcinoid of the ovary: report of a case with metastasis in the contralateral ovary after ten years

    Directory of Open Access Journals (Sweden)

    Patricia C. Ewing

    2010-09-01

    Full Text Available Monodermal teratomas of the ovary can take the form of carcinoid tumors of which there are several types, mucinous carcinoid being the least common. Very few cases of primary mucinous carcinoid of the ovary have been reported in the literature and the behavior of these tumors over the long term is unclear. We describe a case of primary mucinous carcinoid of the ovary in a 39-year-old woman treated with unilateral salpingo-oophorectomy, where a metastasis occurred in the contralateral ovary ten years later. This case demonstrates that mucinous carcinoid of the ovary can metastasize even after a long interval, and careful follow-up of patients, particularly those treated conservatively, is appropriate.

  6. Axillary node metastasis from differentiated thyroid carcinoma with hürthle and signet ring cell differentiation. A case of disseminated thyroid cancer with peculiar histologic findings

    Directory of Open Access Journals (Sweden)

    Chiofalo Maria

    2012-02-01

    Full Text Available Abstract Background Differentiated thyroid cancer is usually associated with an excellent prognosis and indolent course. Distant metastases are rare events at the onset of thyroid cancer. Among these presentations, metastasis to the axillary lymph nodes is even more unusual: only few cases were previously reported in the literature; there has been no report of axillary lymph node metastasis from follicular thyroid carcinoma. Axillary lymph node metastasis generally arises in the context of disseminated disease and carries an ominous prognosis. Case presentation Here we present a case of axillary lymph node metastasis in the context of disseminated differentiated thyroid cancer. The patient underwent near total thyroidectomy and neck and axillary lymph node dissection. A histopathological diagnosis of poorly differentiated follicular carcinoma with "signet ring cells" and Hürthle cell features was established. The patient received radioactive iodine therapy and TSH suppression therapy. Subsequently his serum thyroglobulin level decreased to 44.000 ng/ml from over 100.000 ng/ml. Discussion and Conclusion Currently there are only few reported cases of axillary node metastases from thyroid cancer, and to our knowledge, this is the first report on axillary lymph node metastasis from follicular thyroid carcinoma. "Signet ring cell" is a morphologic feature shared by both benign and, more rarely, malignant follicular thyroid neoplasm, and it generally correlates with an arrest in folliculogenesis. Our case is one of the rare "signet ring cells" carcinomas so far described.

  7. A Case Report of Unilateral Severe Visual Loss Along with Bilateral Optic Disc Cupping Secondary to Metastatic Brain Tumor

    Directory of Open Access Journals (Sweden)

    M Mahdavi

    2006-07-01

    Full Text Available Purpose: To report a case of unilateral severe visual loss and bilateral optic disc cupping secondary to brain metastasis of bronchogenic carcinoma Patient and findings: A 48 year-old woman presented with severe visual loss of left eye without redness or pain or any systemic findings .Clinical findings included decreased visual acuity of left eye to 4 m CF and (+3 positive Marcus-Gunn reflex .There was asymmetric optic disc cupping associated with visual field defect in left eye The neurologic investigations showed a secondary metastatic tumor in the brain from bronchogenic carcinoma. Conclusion: Before making a diagnosis of normal -tension glaucoma in asymmetric optic disc cupping and normal intraocular pressure, ophthalmologists should rule out neurologic defects and brain tumors.

  8. Ten-Year Survival of a Patient Treated with Stereotactic Gamma Knife Radiosurgery for Brain Metastases from Colon Cancer with Ovarian and Lymph Node Metastases: A Case Report

    Directory of Open Access Journals (Sweden)

    Nobuhiro Morinaga

    2016-05-01

    Full Text Available Brain metastasis from colorectal cancer is infrequent and carries a poor prognosis. Herein, we present a patient alive 10 years after the identification of a first brain metastasis from sigmoid colon cancer. A 39-year-old woman underwent sigmoidectomy for sigmoid colon cancer during an emergency operation for pelvic peritonitis. The pathological finding was moderately differentiated adenocarcinoma. Eleven months after the sigmoidectomy, a metastatic lesion was identified in the left ovary. Despite local radiotherapy followed by chemotherapy, the left ovarian lesion grew, so resection of the uterus and bilateral ovaries was performed. Adjuvant chemotherapy with tegafur-uracil (UFT/calcium folinate (leucovorin, LV was initiated. Seven months after resection of the ovarian lesion, brain metastases appeared in the bilateral frontal lobes and were treated with stereotactic Gamma Knife radiosurgery. Cervical and mediastinal lymph node metastases were also diagnosed, and irradiation of these lesions was performed. After radiotherapy, 10 courses of oxaliplatin and infused fluorouracil plus leucovorin (FOLFOX were administered. During FOLFOX administration, recurrent left frontal lobe brain metastasis was diagnosed and treated with stereotactic Gamma Knife radiosurgery. In this case, the brain metastases were well treated with stereotactic Gamma Knife radiosurgery, and the systemic disease arising from sigmoid colon cancer has been kept under control with chemotherapies, surgical resection, and radiotherapy.

  9. SU-E-QI-21: Iodinated Contrast Agent Time Course In Human Brain Metastasis: A Study For Stereotactic Synchrotron Radiotherapy Clinical Trials

    Energy Technology Data Exchange (ETDEWEB)

    Obeid, L; Esteve, F; Adam, J [Grenoble Institut des Neurosciences, La Tronche, Isere (France); Tessier, A; Balosso, J [Centre Hospitalier Universitaire, La Tronche, Isere (France)

    2014-06-15

    Purpose: Synchrotron stereotactic radiotherapy (SSRT) is an innovative treatment combining the selective accumulation of heavy elements in tumors with stereotactic irradiations using monochromatic medium energy x-rays from a synchrotron source. Phase I/II clinical trials on brain metastasis are underway using venous infusion of iodinated contrast agents. The radiation dose enhancement depends on the amount of iodine in the tumor and its time course. In the present study, the reproducibility of iodine concentrations between the CT planning scan day (Day 0) and the treatment day (Day 10) was assessed in order to predict dose errors. Methods: For each of days 0 and 10, three patients received a biphasic intravenous injection of iodinated contrast agent (40 ml, 4 ml/s, followed by 160 ml, 0.5 ml/s) in order to ensure stable intra-tumoral amounts of iodine during the treatment. Two volumetric CT scans (before and after iodine injection) and a multi-slice dynamic CT of the brain were performed using conventional radiotherapy CT (Day 0) or quantitative synchrotron radiation CT (Day 10). A 3D rigid registration was processed between images. The absolute and relative differences of absolute iodine concentrations and their corresponding dose errors were evaluated in the GTV and PTV used for treatment planning. Results: The differences in iodine concentrations remained within the standard deviation limits. The 3D absolute differences followed a normal distribution centered at zero mg/ml with a variance (∼1 mg/ml) which is related to the image noise. Conclusion: The results suggest that dose errors depend only on the image noise. This study shows that stable amounts of iodine are achievable in brain metastasis for SSRT treatment in a 10 days interval.

  10. SU-E-QI-21: Iodinated Contrast Agent Time Course In Human Brain Metastasis: A Study For Stereotactic Synchrotron Radiotherapy Clinical Trials

    International Nuclear Information System (INIS)

    Purpose: Synchrotron stereotactic radiotherapy (SSRT) is an innovative treatment combining the selective accumulation of heavy elements in tumors with stereotactic irradiations using monochromatic medium energy x-rays from a synchrotron source. Phase I/II clinical trials on brain metastasis are underway using venous infusion of iodinated contrast agents. The radiation dose enhancement depends on the amount of iodine in the tumor and its time course. In the present study, the reproducibility of iodine concentrations between the CT planning scan day (Day 0) and the treatment day (Day 10) was assessed in order to predict dose errors. Methods: For each of days 0 and 10, three patients received a biphasic intravenous injection of iodinated contrast agent (40 ml, 4 ml/s, followed by 160 ml, 0.5 ml/s) in order to ensure stable intra-tumoral amounts of iodine during the treatment. Two volumetric CT scans (before and after iodine injection) and a multi-slice dynamic CT of the brain were performed using conventional radiotherapy CT (Day 0) or quantitative synchrotron radiation CT (Day 10). A 3D rigid registration was processed between images. The absolute and relative differences of absolute iodine concentrations and their corresponding dose errors were evaluated in the GTV and PTV used for treatment planning. Results: The differences in iodine concentrations remained within the standard deviation limits. The 3D absolute differences followed a normal distribution centered at zero mg/ml with a variance (∼1 mg/ml) which is related to the image noise. Conclusion: The results suggest that dose errors depend only on the image noise. This study shows that stable amounts of iodine are achievable in brain metastasis for SSRT treatment in a 10 days interval

  11. VON RECKLINGHAUSEN’S DISEASE ASSOCIATED WITH PAPILARY THYROID CARCINOMA AND MALIGNANT MELANOMA WITH MULTIPLE METASTASISCASE REPORT

    Directory of Open Access Journals (Sweden)

    D. Niculescu

    2006-04-01

    Full Text Available We present the case of a 56 years old, women, known with Recklinghausen’s Disease (RD since 15 years old. She was in the evidence of Iasi Endocrynology Clinic with nodulary goitre since ’97, being treated with Euthyrox until 2005. Due to symptomatology worsening (asphyxia feeling, agitation, palpitations, insomnia, irritability, dizziness and to thyroid increase the surgical procedure was recommended. A right lobeisthmectomy was performed in 2005, but the Histopathology Exam revealed an occult Papillary Thyroid Carcinoma (PTC pT1NxMxG1 (sclerous infiltrative 3 mm node on joint nodular goitre with metaplasia, hemorrhage, sclero hyalinisation and lymphomatous thyroiditis aspects. She was treated with L Thyroxin, chemotherapy (Cisplatinum, Dacarbazin and radioactive iodine therapy. After oncological evaluation she was addressed to the First Surgery Clinic for thyroidectomy totalisation and the treatment of an umbilical tumour occurred after the fourth cure (June-July 2005. The patient was evaluated by physical exam, ultrasonography and computed tomography (cervical and abdominal which revealed tumours in the cervical region and in the liver. Thyroidectomy totalisation with limphadenectomy and an abdominal laparoscopy and biopsy were performed. The pathologic exam diagnosed multiple metastasis of malignant melanoma (MM localized in the cervical region, in the liver, great omentum and cervical limphatic nodes. The postoperative follow-up revealed multiple bone mestastasis from the malignanat melanoma. The case particularities were: association of RD with 2 primitive malignant tumours (occult PTC and MM, both diagnosed histopathologically and the multiple bone metastasis developed in a short time.

  12. Longitudinally Extensive Transverse Myelitis with Intramedullary Metastasis of Small-Cell Lung Carcinoma: An Autopsy Case Report

    Directory of Open Access Journals (Sweden)

    Kenya Nishioka

    2013-01-01

    Full Text Available Background. Longitudinally extensive transverse myelitis (LETM is characterized by spinal cord inflammation extending vertically through three or more vertebral segments. The widespread use of MRI revealed LETM more frequency than ever. We report the case of a patient with pathologically confirmed small-cell lung carcinoma metastasis into the spinal cord presenting as LETM. Case Presentation. A 74-year-old man developed rapidly progressive sensorimotor disturbance and vesicorectal dysfunction. T2-weighted magnetic resonance imaging of the spine revealed LETM at the level of from T3 to conus medullaris; gadolinium enhancement showed concurrent tumor in the thoracic spinal cord from T10 to T11. Systemic survey identified a nodular mass in the lung that was verified as small-cell carcinoma. Following initial failed treatment by high-dose steroid, the patient underwent an emergent microsurgical tumor resection. Histological examination was identical with the lung carcinoma. The patient died of tumor progression at the 47th day after admission. At autopsy, only changes of edema were found in the gray matter of the cord, while tumor cells were not noted in it. Conclusion. Metastasis may rarely present symptoms of LETM. Prompt identification of underlying etiology by contrast examination and systemic survey is crucial for the patient assumed as LETM.

  13. Repeat stereotactic radiosurgery in the management of brain metastases from NSCLC: A case report and review of the literature.

    Science.gov (United States)

    Marvaso, Giulia; Barone, Agnese; Vaccaro, Caterina; Bruzzaniti, Vicente; Grespi, Silvia; Scotti, Valerio; Bianco, Cataldo

    2013-10-01

    The aims of radiotherapeutic treatment of brain metastases include maintaining neurocognitive function and improvement of survival. Based on these premises, we present a case report in which the role of repeat stereotactic radiosurgery (SRS) was investigated in a patient with a recurrent brain metastasis from non-small cell lung cancer in the same area as previously treated with radiosurgery. A 40-year-old male caucasian patient was diagnosed with brain metastasis from non-small cell lung cancer (NSCLC) and underwent SRS. The patient developed a recurrence of the disease and a second SRS on the same area was performed. After 8 months, tumor restaging demonstrated a lesion compatible with a recurrence and the patient underwent surgery. Histological diagnosis following surgery revealed only the occurrence of radionecrosis. Radiotherapy was well-tolerated and no grade 3/4 neurological toxicity occurred. To date, no consensus exists on the efficacy of retreatment with SRS. Despite the limited number of studies in this field, in the present case report, we outline the outcomes of this unconventional approach. PMID:24137433

  14. Brain metastases of malignant melanoma in Chinese:report of 23 cases

    Institute of Scientific and Technical Information of China (English)

    WANG Yi-chou; LEE Shih-tseng

    2007-01-01

    Background Patients with melanoma metastasized to the central nervous system have a poor prognosis. Because the incidence of malignant melanoma in the Oriental is lower than that in the Caucasian population, brain metastases of malignant melanoma are rarely reported in Asia. Here we present our experience of brain metastasis of melanoma in an Asian perspective.Methods From 1990 to 2003, 369 patients with melanoma were treated in our hospital, 26 of them were diagnosed as having central nervous system involvement. Of the 26 cases, the clinical history, image, and pathologic findings of 23 patients were analyzed; the other 3 were excluded because of incomplete clinical data.Results Among the 369 patients with melanoma, 45% (167/369) developed lower extremity melanoma, and 27.1%(100/369) had acral lentiginous melanoma (ALM); while in the 23 patients with brain metastases, 34.7% (8/23) had lower extremity melanoma, and 34.7% (8/23) had ALM. Among the 23 patients, 17 had acute hemorrhage into the tumor,8 initially presented with a single cerebral metastatic lesion, and 15 had multiple brain lesions. Ten of them received surgery, 3 underwent stereotactic radiosurgery, and 16 received whole brain radiation. During follow-up, only 2 patients survived for more than 1 year, the median survival period was 5 months. The longest follow-up period was 11 years.Conclusions Compared with the Caucasian, Chinese patients with melanoma have a different proportion of melanoma subtype and higher incidence rates of lower extremities melanoma and ALM. However, their clinical presentation and prognosis are similar. The patients, who have excisable single or multiple brain lesions or limited extracranial disease and who are actively treated, may survive longer.

  15. Axillary node metastasis from differentiated thyroid carcinoma with hürthle and signet ring cell differentiation. A case of disseminated thyroid cancer with peculiar histologic findings

    International Nuclear Information System (INIS)

    Differentiated thyroid cancer is usually associated with an excellent prognosis and indolent course. Distant metastases are rare events at the onset of thyroid cancer. Among these presentations, metastasis to the axillary lymph nodes is even more unusual: only few cases were previously reported in the literature; there has been no report of axillary lymph node metastasis from follicular thyroid carcinoma. Axillary lymph node metastasis generally arises in the context of disseminated disease and carries an ominous prognosis. Here we present a case of axillary lymph node metastasis in the context of disseminated differentiated thyroid cancer. The patient underwent near total thyroidectomy and neck and axillary lymph node dissection. A histopathological diagnosis of poorly differentiated follicular carcinoma with 'signet ring cells' and Hürthle cell features was established. The patient received radioactive iodine therapy and TSH suppression therapy. Subsequently his serum thyroglobulin level decreased to 44.000 ng/ml from over 100.000 ng/ml. Currently there are only few reported cases of axillary node metastases from thyroid cancer, and to our knowledge, this is the first report on axillary lymph node metastasis from follicular thyroid carcinoma. 'Signet ring cell' is a morphologic feature shared by both benign and, more rarely, malignant follicular thyroid neoplasm, and it generally correlates with an arrest in folliculogenesis. Our case is one of the rare 'signet ring cells' carcinomas so far described

  16. Neurosyphilis Involving Cranial Nerves in Brain Stem: 2 Case Reports

    International Nuclear Information System (INIS)

    Neurosyphilis uncommonly presents with cranial neuropathies in acute syphilitic meningitis and meningovascular neurosyphilis. We now report two cases in which the meningeal form of neurosyphilis involved cranial nerves in the brain stem: the oculomotor and trigeminal nerve.

  17. Neurosyphilis Involving Cranial Nerves in Brain Stem: 2 Case Reports

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Ji Hye [Dept. of Radiology, Kyung Hee University College of Medicine, Seoul (Korea, Republic of); Choi, Woo Suk; Kim, Eui Jong [Dept. of Radiology, Kyung Hee University Hospital, Seoul (Korea, Republic of); Yoon, Sung Sang; Heo, Sung Hyuk [Dept. of Neurology, Kyung Hee University Hospital, Seoul (Korea, Republic of)

    2012-01-15

    Neurosyphilis uncommonly presents with cranial neuropathies in acute syphilitic meningitis and meningovascular neurosyphilis. We now report two cases in which the meningeal form of neurosyphilis involved cranial nerves in the brain stem: the oculomotor and trigeminal nerve.

  18. Use case: Ontology with rules for identifying brain anatomical structures

    OpenAIRE

    Golbreich, Christine; Bierlaire, Olivier; Dameron, Olivier; Gibaud, Bernard

    2005-01-01

    International audience The proposed use case focuses on interoperating between a rule base and a brain cortex anatomy ontology, in order to assist the labeling of the brain cortex structures - sulci and gyri - involved in MRI images. The use case documents the ontology and the rules so as to clarify the added value and needs of rules, and the language expressiveness required. The expected result is to get candidate languages extending OWL DL with rules that allow representing all the knowl...

  19. Choroidal and cutaneous metastasis from gastric adenocarcinoma

    OpenAIRE

    2013-01-01

    Choroidal or cutaneous metastasis of gastric cancer is rare. Gastrointestinal cancer was found in only 4% in patients with uveal metastasis. Choroidal metastasis from gastric cancer was reported in two cases in earlier literature. The frequency of gastric cancer as a primary lesion was 6% in cutaneous metastasis of men, and cutaneous metastasis occurs in 0.8% of all gastric cancers. We report a patient with gastric adenocarcinoma who presented with visual disorder in his left eye and skin pai...

  20. Collision metastasis of urothelial and prostate carcinomas to the same lymph node: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Bhavsar Tapan

    2012-05-01

    Full Text Available Abstract Introduction A collision tumor is the meeting and eventual intermingling of two malignant neoplasms arising from independent topographical sites. Collision metastasis of carcinomas in the lymph nodes is a rare event. A literature search revealed only three cases of such a collision metastasis of prostatic and urothelial carcinoma, and only one of those cases had used immunohistochemical stains to distinguish the two tumors. Case presentation We encountered a case of this rare entity in an 83-year-old African-American man who presented to our facility with increasing pelvic pain after a transurethral resection of a high-grade bladder tumor and a negative metastatic computed tomography chest, abdomen and pelvic scan investigation. A radical cystoprostatectomy was subsequently performed revealing a multi-centric, high-grade, ill-defined infiltrating urothelial carcinoma infiltrating the right pericystic soft tissue. A histopathological examination of the prostate revealed a multi-centric adenocarcinoma (Gleason 4 + 4 involving two pelvic lymph nodes. Interestingly, while the right pelvic lymph node was positive for metastatic prostatic adenocarcinoma alone, immunohistochemical studies of the left pelvic lymph node revealed a dual metastatic urothelial (cytokeratin-7 and pan-cytokeratin positive, prostate-specific antigen and cytokeratin-20 negative and prostatic (prostate-specific antigen and pan-cytokeratin positive, cytokeratin-7 and cytokeratin-20 negative carcinoma. Conclusions The collision of metastatic urothelial carcinoma and prostatic adenocarcinoma is unusual, and their biological behavior remains uncertain. A high index of suspicion along with thorough clinical examination and immunohistochemical stain results are an integral part of differentiating collision of urothelial carcinoma from prostate carcinoma, particularly when the two tumors are in close proximity with overlapping histological features.

  1. Pancreatic Metastasis of High-Grade Papillary Serous Ovarian Carcinoma Mimicking Primary Pancreas Cancer: A Case Report

    Directory of Open Access Journals (Sweden)

    Yusuf Gunay

    2012-01-01

    Full Text Available Introduction. Reports of epithelial ovarian carcinomas metastatic to the pancreas are very rare. We herein present a metastasis of high grade papillary serous ovarian cancer to mid portion of pancreas. Case. A 42-year-old patient was admitted with a non-specified malignant cystic lesion in midportion of pancreas. She had a history of surgical treatment for papillary serous ovarian adenocarcinoma. A cystic lesion was revealed by an abdominal computerized tomography (CT performed in her follow up . It was considered as primary mid portion of pancreatic cancer and a distal pancreatectomy was performed. The final pathology showed high-grade papillary serous adenocarcinoma morphologically similar to the previously diagnosed ovarian cancer. Discussion. Metastatic pancreatic cancers should be considered in patients who present with a solitary pancreatic mass and had a previous non-pancreatic malignancy. Differential diagnosis of primary pancreatic neoplasm from metastatic malignancy may be very difficult. A biopsy for tissue confirmation is required to differentiate primary and secondary pancreatic tumors. Although, the value of surgical resection is poorly documented, resection may be considered in selected patients. Conclusion. Pancreatic metastasis of ovarian papillary serous adenocarcinoma has to be kept in mind when a patient with pancreatic mass has a history of ovarian malignancy.

  2. Clinical outcomes of HER2-positive metastatic breast cancer patients with brain metastasis treated with lapatinib and capecitabine: an open-label expanded access study in Korea

    Directory of Open Access Journals (Sweden)

    Ro Jungsil

    2012-07-01

    Full Text Available Abstract Background To evaluate efficacy in patients with brain metastasis (BM on entry into the lapatinib expanded access program (LEAP. Methods LEAP is a worldwide, single-arm, open-label study. HER2-positive, locally-advanced or metastatic breast cancer patients with progression after an anthracycline, taxane, and trastuzumab were eligible. Patients received capecitabine 2000 mg/m2 daily in two divided doses, days 1–14, every 21 days and lapatinib 1250 mg once daily. Results Among 186 patients enrolled in 6 Korean centers, 58 had BM. Progression-free survival (PFS was 18.7 weeks in patients with BM and 19.4 weeks without BM (P = 0.88. In patients with BM, brain response was synchronized with systemic responses (P = 0.0001. Overall survival (OS was 48.9 weeks in patients with BM and 64.6 weeks without BM (P = 0.23. Multivariable analysis found hormone receptor positivity (P = 0.003 and clinical benefit rate (CBR of combined systemic and brain disease (P  Conclusion Lapatinib plus capecitabine is equally effective in patients with or without BM. Trial registration ClinicalTrials.gov (NCT00338247

  3. Cases of Renal Cell Carcinoma and Lung Metastasis Sequential Bilateral Pneumothorax

    Directory of Open Access Journals (Sweden)

    Mahmut Tokur

    2013-07-01

    Full Text Available The metastasis of the lungs develop in proportion as 30% of all cancers. Spontaneous pneumothorax is a rarely found but clinically significant complication in lung and trachea tumors. Spontaneous pneumothorax may also occur in metastatic tumors. Different levels of dispnea are observed in metastatic lung tumors according to the prevalance of the lesions. Sudden or progressive incline in the shortness of breath in these patients may be the harbinger of a spontaneous pneumothorax. In this presentation, underwent left nephrectomy with a diagnosis of renal cell carcinoma, bilateral pulmonary metastases after nephrectomy for two years due to the development of spontaneous pneumothorax in consecutive patients given chemotherapy was discussed with the development of literature.

  4. Hemorrhage in cerebral metastasis from angiosarcoma of the heart: case report Hemorragia em metástase cerebral de angiossarcoma cardíaco: relato de caso

    Directory of Open Access Journals (Sweden)

    Pasquale Gallo

    2001-09-01

    Full Text Available The purpose of this article is to describe the clinical and pathological features of metastatic angiosarcoma in the central nervous system. Only a few cases of cerebral metastasis from angiosarcoma of the heart have been recorded in the literature; particulary related to intracerebral hemorrhage. A case of secondary cerebral angiosarcoma of the heart in a 33 years old man is presented. The initial symptoms were headache, vomiting, lethargy and aphasia. There was a mass in the left temporal lobe with hemorrhage and edema on the computerized tomography (CT. After 24 hours the neurological status worsened and another CT scan showed rebleeding on the tumor area. He underwent an emergency craniotomy but died two days after. Considering the longer survival of sarcoma patients with new modalities of treatment, the incidence of brain metastasis may increase, demanding a bether preventive and more aggressive approach. Besides, due to the hemorrhagic nature of such lesions, we suggest the imediate surgery to prevent a fast and lethal evolution because rebleeding.O propósito deste artigo é descrever os achados clínicos e patológicos das metástases de angiossarcoma no sistema nervoso central. Apenas poucos casos de metástases cerebrais de angiossarcoma cardíaco foram relatados na literatura, menos ainda relacionados a hemorragia intracerebral. Relatamos o caso de um tumor cerebral secundário a angiossarcoma cardíaco em um paciente masculino de 33 anos. Os sintomas iniciais foram: cefaléia, vômitos, letargia e afasia. A tomografia computadorizada mostrou massa no lobo temporal esquerdo associada a hemorragia e edema. Após 24 horas houve piora do estado neurológico e nova tomografia demonstrou ressangramento no leito tumoral. Foi submetido a uma craniotomia de urgência mas faleceu dois dias após. Considerando a longa sobrevida dos pacientes com sarcoma devido às novas modalidades terapêuticas, poderá aumentar a incidência de met

  5. Gallbladder metastasis from renal cell carcinoma mimicking acute cholecystitis

    Directory of Open Access Journals (Sweden)

    Sand M

    2009-02-01

    Full Text Available Abstract Renal cell carcinoma constitutes about 3% of adult malignancies. It has a high metastatic potential associated with synchronous or metachronous metastatic disease. Further, it is known to metastasize mainly to the lung, bone, brain, liver, or adrenal glands. In very rare cases it can metastasize to the gallbladder mimicking acute cholecystitis on clinical exam. In this case we present a patient who developed a gallbladder metastasis five years after a renal cell carcinoma mimicking acute cholecystitis.

  6. Intradural extramedullary metastasis from papillary carcinoma of thyroid

    OpenAIRE

    Akhavan, Ali; Mehrabaniyan, Mohammad Reza; Jarahi, Mohammadreza; Navabii, Hossein

    2012-01-01

    Although spinal metastasis is a common finding in malignancies, however intradural extramedullary metastasis is very rare. This paper presents a 71-year-old woman, known case of papillary carcinoma of thyroid with intradural extramedullary metastasis in thoracic spine.

  7. Metastasis of basal cell carcinoma to lymph nodes in a patient with Gorlin syndrome - case report and literature review

    International Nuclear Information System (INIS)

    Background: Basal cell carcinoma of the skin is the most common malignant cancer worldwide. It is characterized by a low grade of malignancy and it gives very rare metastases to lymph nodes or internal organs. It is also a typical symptom of Gorlin syndrome, which is characterized by multiple basal cell carcinomas, calcifications in the central nervous system and palmar or plantar pits. Mutations in the PTCH gene are responsible for the development of this syndrome, and its inheritance is autosomal dominant. The estimated frequency of Gorlin syndrome is 1/57 000 - 256 000. Case report: The authors present a case of a 34-year-old man with Gorlin syndrome and metastasis of basal cell carcinoma of the face to the submandibular lymph node. Though there are some reports of high radiosensitivity in patients with this syndrome, in this case postoperative radiation treatment was used. Inter- and post-treatment observation did not confirm an early or late postradiation reaction higher than score 2 on the EORTC/RTOG scale. Within 20 months after the treatment no new malignant lesions of the irradiated skin were noticed. Discussion: In the literature there are fewer than 300 cases of basal cell carcinoma metastases, of which only 3 concern patients with Gorlin syndrome. On the basis of the case presented the authors suggest that early and late radiation toxicity in Gorlin syndrome patients is not as high as previously believed. (authors)

  8. Kocuria varians infection associated with brain abscess: A case report

    Directory of Open Access Journals (Sweden)

    Tsai Tai-Hsin

    2010-04-01

    Full Text Available Abstract Background Kocuria, established by Stackebrandt et al., previously was classified into Micrococcus. Only two species, K. rosea and K. kristinae are reported to be associated as pathogenic and found with catheter-related bacteremia and acute cholecystitis. Case presentation We herein report the first case of brain abscess caused by Kocuria varians, a gram-positive microorganism, in a 52-year-old man. Hematogenous spread is the probable pathogenesis. Conclusions This report presents a case of Kocuria varians brain abscess successfully treated with surgical excision combined with antimicrobial therapy. In addition, Vitek 2 system has been used to identify and differentiate between coagulase-negative staphylococcus.

  9. Brain-oriented care in the NICU: a case study.

    Science.gov (United States)

    Bader, Lisa

    2014-01-01

    With the advances of technology and treatment in the field of neonatal care, researchers can now study how the brains of preterm infants are different from full-term infants. The differences are significant, and the outcomes are poor overall for premature infants as a whole. Caregivers at the bedside must know that every interaction with the preterm infant affects brain development-it is critical to the developmental outcome of the infant. The idea of neuroprotection is not new to the medical field but is a fairly new idea to the NICU. Neuroprotection encompasses all interventions that promote normal development of the brain. The concept of brain-oriented care is a necessary extension of developmental care in the NICU. By following the journey of 26-week preterm twin infants through a case study, one can better understand the necessity of brain-oriented care at the bedside. PMID:25161134

  10. AMELANOTIC MELANOMA WITH ATYPICAL CLINICAL PRESENTATION AND MULTIPLE METASTASIS

    Directory of Open Access Journals (Sweden)

    Revathy

    2014-11-01

    Full Text Available A 52 year old woman presented with a history of asymptomatic skin lesions over left leg for the past 4 months. On examination she had multiple skin coloured papules and plaques over left leg. Oedema was also seen over left leg. Histopathology and immunohistochemistry proved the diagnosis of malignant melanoma. Radiological investigation showed metastasis to lung, liver and brain. The patient was asymptomatic at the time of admission but she developed rapid metastasis within a very short span of time. This case is reported for the rare atypical presentation of malignant melanoma.

  11. Palbociclib in Treating Patients With Metastatic HER-2 Positive or Triple-Negative Breast Cancer With Brain Metastasis

    Science.gov (United States)

    2016-05-13

    Breast Carcinoma Metastatic in the Brain; Estrogen Receptor Negative; HER2/Neu Negative; HER2/Neu Positive; Progesterone Receptor Negative; Recurrent Breast Carcinoma; Stage IV Breast Cancer; Triple-Negative Breast Carcinoma

  12. Feasibility on using composite gel-alanine dosimetry on the validation of a multiple brain metastasis radiosurgery VMAT technique

    International Nuclear Information System (INIS)

    This work presents an end-to-end test using a composite Gel-Alanine phantom, in order to validate 3-dimensionally the dose distribution delivered by a single isocenter VMAT technique on the simultaneous treatment of multiple brain metastases. The results obtained with the gel and alanine dosimeters are consistent with the expected by the treatment planning system, showing the potential of this multidosimetric approach and validating dosimetrically the multiple brain metastases treatment using VMAT

  13. Successful treatment of a brain-metastasized renal cell carcinoma

    OpenAIRE

    Johnston, Kim W.; Walid, M. Sami

    2009-01-01

    Renal cell carcinoma is an uncommon type of cancer that rarely metastasizes to the brain. The prognosis after discovering brain metastasis has traditionally been dismal. We are presenting a case of renal cell carcinoma with multiple brain metastases that was successfully treated with multimodal therapy including a new type of medication.

  14. CT diagnosis of peritoneal metastasis tumor

    International Nuclear Information System (INIS)

    Objective: To study the CT findings and diagnosis of peritoneal metastasis. Methods: The CT findings of 17 cases with surgical- pathologically proved peritoneal metastasis were analyzed retrospectively. Results The CT findings of peritoneal metastasis included: (1)ascites (12 cases ); (2)the aternation of parietal peritoneum including broad band thickening (7 cases), nodular sign (2 cases), and massive thickening (1 cases); (3) the involved omentum and mesenterium: 'smut' appearances (7 cases), nodular sign (2 cases), 'omental cake' (5 cases); (4) the invlovement of mesenteric vessels; (5) single-or multi-cystic lesions within peritoneum (1 case) . Conclusion: CT scan is the first choice for metastasis of peritoneum. (authors)

  15. PRIMARY NONKERATINIZING SQUAMOUS CARCINOMA OF BREAST WITH IPSILATERAL AXILLARY LYMPH NODE METASTASIS: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Amoolya

    2014-04-01

    Full Text Available Primary squamous carcinoma is a rare type of metaplastic carcinoma of the breast, incidence being less than 0.1% of all breast carcinomas. The non-keratinizing variant can mimic several rare types of breast carcinomas, prognosis and therapeutic modalities of which are dissimilar. Histopathological examination is gold standard in diagnosing these tumors. Accurate diagnosis employing special stains and immunohistochemistry is mandatory as they are triple negative unlike infiltrating ductal carcinoma NOS, and have aggressive course, poor prognosis and distinctive treatment modalities. Other unique features include less frequent axillary nodal metastasis and necessity to rule out metastatic squamous carcinomas to the breast from other primary sites in these patients. We present a 60 years old lady with a hard lump in the left breast, with no significant past history. Physical examination was suggestive of carcinoma of breast with axillary lymphadenopathy. Histopathological examination revealed squamous carcinoma of breast positive for p63 and cytokeratin (CK 5/6. Her chest X-ray, abdominal ultrasonography, oral cavity, laryngobronchoscopy, cystoscopy and cervical Pap smears were unremarkable ruling out the possibility of primary squamous tumor in other common organs

  16. Metastasis in soft tissue as the first manifestation of lung cancer: a case report

    International Nuclear Information System (INIS)

    Full text: Material and methods: A 54-years-old male was admitted to our hospital with a palpable mass in the anterior sub navel abdominal wall. He had shortness of breath, coughing and fatigue since a month. The patient was a heavy smoker for years. Computed tomography (CT) was used for imaging assessment. Results: In the chest a focal lesion (∼1.6 cm) was detected in the right upper lobe of lung, with pleural extrapolations and coexisted sizeable lymph node swelling in the mediastinum. The findings were compatible with a primary lung tumor. In the abdomen, a solid lesion (4 cm diameter) that was enhanced after contrast injection was recognized in the anterior abdominal wall, medial and left of the mid line below the umbilicus, which adhered to the anterior surface of the left rectus abdominis muscle and showcased in the subcutaneous fat. The lesion was suspected to be a metastasis and its biopsy with a fine needle was performed under CT guidance. We preferred not to puncture the lung lesion in order to prevent complications. The diagnosis was confirmed for an adenocarcinoma. Conclusion: Subcutaneous metastases of lung adenocarcinoma is a rare manifestation of the disease. Contrast enhanced CT plays a great role for the first evaluation of the patient and for scheduling a diagnostic plan

  17. Carcinoma de células renais com metástase cutânea: relato de caso Renal cell carcinoma with cutaneous metastasis: case report

    Directory of Open Access Journals (Sweden)

    Thaís Alves de Paula

    2010-06-01

    Full Text Available O adenocarcinoma do rim, ou hipernefroma, é a terceira neoplasia mais comum do trato geniturinário, sendo o de células claras o tipo principal, representando 60% dos casos, com pico de incidência entre 50 e 70 anos. A presença de metástase ao diagnóstico acomete em torno de 30% dos pacientes, tendo como principais sítios pulmões, ossos, pele, fígado e cérebro. Relatamos o caso de um paciente portador de carcinoma de células renais com metástase ao diagnóstico que, apesar de inserido na faixa etária predominante, tipo histológico mais frequente e quadro clínico característico, apresentava metástase a distância em local pouco observado na prática clínica. O paciente evoluiu para o óbito sem tempo hábil para o tratamento.Renal cell carcinoma or hypernephroma is the third most common neoplasia of the genitourinary tract. Its most common type, representing 60% of the cases, is the clear cell carcinoma, with an incidence peak between 50 and 70 years. Metastases are present at the time of diagnosis in approximately 30% of the patients, the major sites being lungs, bones, skin, liver, and brain. We report the case of a male patient with renal cell carcinoma, whose age, clinical findings, and tumor histological type matched with the most common ones for that pathology. Nevertheless, he already had distant metastasis in an uncommon site at the time of diagnosis. The patient died without undergoing specific treatment for renal cell carcinoma.

  18. Pitfalls in brain death diagnosis: a case report.

    Science.gov (United States)

    Ruess, Daniel; Rieger, Bernhard; Goldbrunner, Roland; Schlacke, Hans-Peter

    2013-05-01

    Although there are distinct guidelines in nearly all countries, a reliable secure assessment of brain death in cases with open head injury can be challenging. We present a case of a 32-year-old man with severe head injury after intracranial penetration of a grindstone fragment. As the injury led to destruction of nearly the whole greater wing of the right sphenoid bone and parts of the right orbit, the examination of brainstem reflexes and the confirmation of brain death was unfeasible. On day 2, all clinical criteria of brain death (coma, absence of brainstem reflexes, apnea) were fulfilled. In addition, there was an extinction of brainstem auditory (BAEP) and cerebral (N20) components of median nerve somatosensory evoked potentials, while electroencephalogram (EEG) activity was still present. In the following days, a persisting EEG activity was obtained. Thus, an irreversible loss of whole brain functions could not be proved. As the patient had agreed to organ donation in case of brain death several years ago, ancillary methods to test the cessation of cerebral blood flow were mandatory. However, in this patient these methods turned out either to be doubtful or unavailable. For example, values of transcranial Doppler ultrasonography are not reliable in cases with open head injury. Due to a progressive septic state, time was running out to get the radiopharmaceutical agent for a cerebral scintigraphy (delivery time about 7 days, as the radiopharmaceutical agent was not in stock). Referring to the actual German guidelines, we had no legitimating indication for a cerebral angiography. Finally, the patient died of sepsis. We discuss the widening of the German guidelines in assessing brain death with the fast and low-risk method of cerebral computed tomography-angiography (CTA) to confirm diagnosis of brain death. PMID:22899230

  19. Papillary thyroid microcarcinoma presenting as skull base metastasis

    Institute of Scientific and Technical Information of China (English)

    YAN Bo; LIU Dian-gang; L(U) Hai-li; ZHANG Qiu-hang

    2010-01-01

    @@ Papillary thyroid carcinoma (PTC) is the most common type of well-differentiated thyroid cancer and is considered to be a relatively indolent tumor in which distant metastasis and death are rare.1 The metastasis of PTC is usually to regional lymph nodes, especially the cervical and mediastinal nodes. Metastases to the brain are rare, and constitute 0.1%-5.0% of distant metastases of papillary carcinoma.2 Skull metastasis is uncommon,and is found in 2.5%-5.8% of cases of thyroid cancer.3 Skull base metastasis of PTC is extremely rare, with only eight reported cases in the literature involving the clivus,cavernous sinus, sella turcica, and the petrous apex and ridge.4 A metastatic lesion can arise from histologically benign and silent thyroid neoplasms,5 and differential diagnosis between ectopic and metastatic thyroid cancer can be difficult,6 therefore, the management of thyroid cancer is controversial after removal of metastatic disease.Here we reported a case of papillary thyroid microcarcinoma (PTMC) that was manifested as a solitary clivus metastasis and discussed the diagnostic and therapeutic management strategies. The 73-year-old patient presented with visual impairment in the right eye,and epistaxis. The patient subsequently underwent complete total thyroidectomy after a diagnosis of papillary microcarcinoma. This finding emphasizes that clinically significant metastases can arise from thyroid papillary microcarcinoma. Total thyroidectomy and careful review of the histology are necessary to prevent delay in proper diagnosis.

  20. Cytokine Gene Polymorphisms in Egyptian Cases with Brain Tumors

    International Nuclear Information System (INIS)

    Background: Cytokines are proposed to play important roles in brain tumor biology as well as neuro degeneration or impaired neuronal function. Objectives: This work aimed to check the association of polymorphisms of cytokine genes in Egyptian cases with brain tumors. Methods: This work included 45 cases affected by brain tumors diagnosed as 24 benign and 21 malignant. Their median age was 45 years, and they were 20 males and 25 females. These cases were taken randomly from the Neurosurgery Department of Mansoura University Hospital, Egypt. Case genotypes were compared to 98 healthy unrelated controls from the same locality. DNA was amplified using PCR utilizing sequence specific primers (SSP) for detection of polymorphisms related to TNF-a-308 (G/A), IL-10-1082 (G/A), IL-6-174 (G/C) and IL-1Ra (VNTR) genes. Results: Cases affected with benign brain tumors showed a significant higher frequency of IL-10-1082 A/A [odds ratio (OR=8.0), p<0.001] and IL-6-174 C/C (OR=6.3, p=0.002) homozygous genotypes as compared to controls. Malignant cases, on the other hand, showed significantly higher frequency of IL-6-174 C/C (OR =4.8, p=0.002) homozygous genotype and TNF-a-308 A/A (OR=4.9, p<0.001) homozygous genotype when compared to controls. In the meantime, all cases showed no significant difference regarding the distribution of IL-1Ra VNTR genotype polymorphism compared to controls. Conclusions: Cytokine gene polymorphisms showed a pattern of association with brain tumors which may have potential impact on family counseling and disease management.

  1. A case report of metastasis of malignant mesothelioma to the oral gingiva

    OpenAIRE

    Moser, Stephanie; Beer, Marc; Damerau, Georg; Lübbers, Heinz-Theo; Grätz, Klaus W; Kruse, Astrid L

    2011-01-01

    Introduction: Metastatic mesothelioma to the oral cavity arises from the pleura or peritoneum and distant hematogenous metastases are seen in more than half of cases but only a few cases are reported to the oral cavity. Case: A 75 year old male suffering from metastatic mesothelioma presents an hyperplasia of the attached gingiva. Malignant mesothelioma is a rare tumour arising from pleura, pericardium or peritoneum. Conclusion: This article highlights the importance of biops...

  2. Computed tomography in brain metastases of colorectal cancer

    International Nuclear Information System (INIS)

    Metastatic brain tumors from colorectal cancers are relatively rare. In previous reports, the incidence ranged from 3 to 5 percent of all metastatic brain tumors. We report 7 cases of metastatic brain tumors from colorectal cancers. The time interval from the diagnosis of the primary tumors to the brain metastasis was 3 years on the average. Metastasis to the lung and liver were also found in 6 cases at the time of the diagnosis of the brain metastasis. The CEA levels in the serum were highly elevated in all cases. Solitary metastasis was found in all cases; cancers tend to metastasize in the deep area of the cerebrum or cerebellum. On a plain CT scan, tumors were demonstrated as ring-type, with a high-density mass, and ring-like enhancement was seen in 6 cases. Prognosis was very poor in most cases. The median survival time from diagnosis of brain metastasis was 4.5 months in the 2 cases with surgery and 3.5 months in the 4 cases without surgery. (author)

  3. Cutaneous metastasis of testicular choriocarcinoma, diagnosed by fine-needle aspiration cytology: A rare case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Bita Geramizadeh

    2012-01-01

    Full Text Available Skin metastasis of testicular choriocarcinoma is very rare. Until now about nine cases have been reported in the English literature; however, only one of them has been diagnosed by fine-needle aspiration (FNA cytology. Herein, we report our experience with FNA cytology diagnosis of a metastatic testicular choriocarcinoma to the skin of chin. The combination of highly atypical mononuclear cells (cytotrophoblasts and multinucleated malignant cells (syncytiotrophoblasts are characteristic of metastatic tumor in a known case of choriocarcinoma of testis.

  4. Pedunculated hepatocellular carcinoma and splenic metastasis

    Institute of Scientific and Technical Information of China (English)

    Mao-Lin Yan; Yao-Dong Wang; Zhi-De Lai; Yi-Feng Tian; Hong-Biao Chen; Fu-Nan Qiu; Song-Qiang Zhou

    2009-01-01

    Only a few cases of pedunculated hepatocellular carcinoma (P-HCC) have been reported in the literature. The common sites of extrahepatic metastases in patients with HCC are the lungs, regional lymph nodes,kidney, bone marrow and adrenals. Metastasis to spleen is mostly via hematogenous metastasis, direct metastasis to spleen was very rare. We report a case of P-HCC presenting as a left upper abdominal lesions which involved the spleen that was actually a P-HCC with splenic metastasis. This case is unique as P-HCC directly involved the spleen which is not via hematogenous metastasis.

  5. Choroidal metastasis from carcinoma of breast detected on 18F-FDG PET CT scan: a case report and review of literature

    International Nuclear Information System (INIS)

    Intraocular choroidal metastasis is a very rare cause of blindness. Choroidal hemangioma and melanoma are other causes that may mimic the condition. Carcinoma of breast is the most common primary malignancy that accounts for choroidal metastasis in females and carcinoma of lung is the most common cause in males. Other primary neoplasms which can uncommonly metastasize to the choroid are testis, gastrointestinal tract, kidney, thyroid, pancreas, and prostate. Metastatic neoplasm to the eye outnumbers the primary tumors such as retinoblastomas and malignant melanoma. Sonography is usually the initial investigation after fundus examination to look for the architecture of the lesion. However, it lacks in specificity. We present a case of carcinoma of breast that had visual disturbances and wholebody 18F-fluorodeoxyglucose, positron emission tomography-computerized tomography (FDG PET CT) revealed a choroidal lesion in addition to cerebral, pulmonary, and skeletal metastases. Choroidal metastasis from carcinoma of lung has been reported previously on FDG PET. To the best of our knowledge, this is the first case report of carcinoma of breast demonstrating choroid metastasis on 18F-FDG PET CT scan. (author)

  6. Case report: MRI of the brain in metronidazole toxicity

    International Nuclear Information System (INIS)

    Metronidazole is a commonly used antimicrobial drug. When used excessively, it can cause encephalopathy. We report the MRI findings in one such case. A 43-year-old male patient was treated with metronidazole for 2 months, for an amebic liver abscess and presented with neurological signs and symptoms. MRI of the brain showed findings consistent with metronidazole toxicity

  7. Kocuria varians infection associated with brain abscess: A case report

    OpenAIRE

    Tsai Tai-Hsin; Chou Yu-lin; Cheng Yu-Hsin; Su Shou-hsin; Tsai Cheng-Yu; Lieu Ann-Shung

    2010-01-01

    Abstract Background Kocuria, established by Stackebrandt et al., previously was classified into Micrococcus. Only two species, K. rosea and K. kristinae are reported to be associated as pathogenic and found with catheter-related bacteremia and acute cholecystitis. Case presentation We herein report the first case of brain abscess caused by Kocuria varians, a gram-positive microorganism, in a 52-year-old man. Hematogenous spread is the probable pathogenesis. Conclusions This report presents a ...

  8. A case of burn encephalopathy with reversible brain atrophy on brain computed tomography (CT)

    International Nuclear Information System (INIS)

    We present an interesting case of burn encephalopathy. The patient is a three-year-old girl with second to third degree and 30 % scald burn. She developed central nervous symptom on the second day with high fever and systemic convulsions and was transferred to our clinic on the third day from a local hospital. Her level of consciousness was 30 to 100 (3-3-9 formula) and she developed extra-pyramidal involuntary movement; these neurological signs persisted untill 66th day when she spoke for the first time since admission. Her EEG showed diffuse brain dysfunction and CT showed marked brain atrophy. She began to improve after around 50 days systematically as well as neurologically and was discharged after four months. EEG, CT findings and neurological signs were normal 1.5 years later. We could not find a case of reversible brain atrophy in the reports on burn encephalopathy or other neurological disorders except for the cases of long-term steroid administration on autoimmune diseases or ACTH therapy on infantile spasm. In our case, the reversible brain atrophy might be caused by the rise of endogenous steroid under burn stress, or transient malfunction of cerebro-spinal fluid absorption, or some other causes. (author)

  9. Multiple brain abscesses: A case report

    OpenAIRE

    Banić-Horvat Sofija; Cvijanović Milan; Ilin Miroslav; Kopitović Aleksandar; Simić Svetlana; Jovin Zita

    2004-01-01

    Case Report 10 days before admission a 45-year old female experienced general weakness, and T 38oC. During that period she had no cardio-respiratory nor neurological complaints, and the temperature varied between 37.5oC and 38oC. Her medical history was unremarkable, without immunodeficiency. The day before admission she presented with left arm paresis and during the next day it progressed to paralysis. She had no headache. On admission the following diagnostic procedures were performed: the ...

  10. Small primary adenocarcinoma in adenomyosis with nodal metastasis: a case report

    OpenAIRE

    Campagnutta Elio; Gloghini Annunziata; Nomura Kazuhito; Perin Tiziana; Shozu Makio; Puppa Giacomo; Canzonieri Vincenzo

    2007-01-01

    Abstract Background Malignant transformation of adenomyosis is a very rare event. Only about 30 cases of this occurrence have been documented till now. Case presentation The patient was a 57-year-old woman with a slightly enlarged uterus, who underwent total hysterectomy and unilateral adnexectomy. On gross inspection, the uterine wall displayed a single nodule measuring 5 cm and several small gelatinous lesions. Microscopic examination revealed a common leiomyoma and multiple adenomyotic foc...

  11. A Case of Nongerminomatous Germ Cell Tumor with Fulminant Course Concomitant Leptomeningeal Metastasis.

    Science.gov (United States)

    Jeong, Youn-Beom; Wang, Kyu-Chang; Phi, Ji Hoon; Lee, Ji Yeoun; Cheon, Jung-Eun; Kang, Hyoung Jin; Kim, Il Han; Kim, Seung-Ki

    2016-04-01

    We present the case of a 9-year-old boy with a non-germinomatous germ cell tumor (NGGCT) in the pineal gland that exhibited a fulminant course following chemo- and radiotherapy. After the detection of the tiny cerebellar enhancing nodule at the end of chemo- and radiotherapy, tumor seeding progressed rapidly into the entire cisternal space. We herein report a rare case of NGGCT with fulminant clinical course of concomitant cerebellar seeding, with review of literature. PMID:27195258

  12. Late onset leptomeningeal and whole spine metastasis from supratentorial Glioblastoma multiforme: An uncommon manifestation of a common tumor.

    Science.gov (United States)

    Sharma, Divyam; Gupta, Anshul; Dhillon, Gurupal S; Chhabra, Satnam Singh

    2016-01-01

    Glioblastoma multiforme (GBM) is one of the most common and aggressive primary brain tumors, composing 12-20% of all the intracranial tumors in adults with a highly malignant course and average life expectancy of approximately 12-14 months following initial diagnosis. Leptomeningeal or intramedullary metastasis from primary GBM is a rare phenomenon with a poor prognosis. We present a rare case of GBM with late onset intramedullary, extramedullary, as well as leptomeningeal spinal metastasis. PMID:27217661

  13. Late onset leptomeningeal and whole spine metastasis from supratentorial Glioblastoma multiforme: An uncommon manifestation of a common tumor

    OpenAIRE

    Divyam Sharma; Anshul Gupta; Gurupal S Dhillon; Satnam Singh Chhabra

    2016-01-01

    Glioblastoma multiforme (GBM) is one of the most common and aggressive primary brain tumors, composing 12-20% of all the intracranial tumors in adults with a highly malignant course and average life expectancy of approximately 12-14 months following initial diagnosis. Leptomeningeal or intramedullary metastasis from primary GBM is a rare phenomenon with a poor prognosis. We present a rare case of GBM with late onset intramedullary, extramedullary, as well as leptomeningeal spinal metastasis.

  14. Renal cell carcinoma with metastasis to the submandibular and parotid glands A case report

    NARCIS (Netherlands)

    Smits, J.G.; Slootweg, P.J.

    1984-01-01

    Differential diagnosis between acinic cell carcinoma and renal cell carcinoma is an oft-quoted problem. A case is presented of a 60-year-old woman with metastatic lesions from a renal cell carcinoma to the parotid as well as the submandibular gland. Appropriate diagnosis was delayed due to lack of c

  15. Extraneural Glioblastoma Multiforme Vertebral Metastasis

    Science.gov (United States)

    Goodwin, C. Rory; Liang, Lydia; Abu-Bonsrah, Nancy; Hdeib, Alia; Elder, Benjamin D.; Kosztowski, Thomas; Bettegowda, Chetan; Laterra, John; Burger, Peter; Sciubba, Daniel M.

    2016-01-01

    Glioblastoma multiforme (GBM) is the most common malignant central nervous system tumor; however, extraneural metastasis is uncommon. Of those that metastasize extraneurally, metastases to the vertebral bodies represent a significant proportion. We present a review of 28 cases from the published literature of GBM metastasis to the vertebra. The mean age at presentation was 38.4 years with an average overall survival of 26 months. Patients were either asymptomatic with metastasis discovered at autopsy or presented with varying degrees of pain, weakness of the extremities, or other neurologic deficits. Of the cases that included the time to spinal metastasis, the average time was 26.4 months with a reported survival of 10 months after diagnosis of vertebral metastasis. A significant number of patients had no treatments for their spinal metastasis, although the intracranial lesions were treated extensively with surgery and/or adjuvant therapy. With increasing incremental gains in the survival of patients with GBM, clinicians will encounter patients with extracranial metastasis. As such, this review presents timely information concerning the presentation and outcomes of patients with vertebral metastasis. PMID:26704201

  16. Lung Metastasis in a Case of Recurrent Poorly Differentiated Leiomyosarcoma of the Bartholin Gland: A Case Report and Review of the Literature.

    Science.gov (United States)

    Alnafisah, Fatimah; Alfieri, Joanne

    2016-01-01

    Vulvar neoplasms represent four percent of all gynecological cancers. While most cases of vulvar neoplasms are benign, two percent of patients present with malignant disease. We present the case of a 37-year-old premenopausal female who presented to an outside institution with a lump in her left vulva, which had progressively enlarged to the size of an egg. A wide local excision of the left vulva was performed, and the pathology revealed a high-grade sarcoma, not otherwise specified (NOS), with negative margins. Imaging showed enlarged bilateral external iliac lymph nodes, likely metastatic. After discussion at a multidisciplinary gynecology oncology tumor board, she was treated with gemcitabine/docetaxel chemotherapy, followed by a left inguinal lymph node dissection and a left radical vulvectomy after being referred to our centre. The final pathology at that time showed a residual sarcoma of 3.5 mm in the left vulva with no lympho-vascular invasion (LVI) and negative margins, with the closest, laterally, at 2 mm. A total of three lymph nodes were negative. She received additional chemotherapy postoperatively. Approximately one year later, she returned to her gynecologist with a 1 cm mass on the left vulva. She underwent a left hemi-vulvectomy and lymph node dissection, and pathology confirmed the presence of a high-grade sarcoma with close margins. She received adjuvant radiotherapy. Three months later, she presented with persistent cough and pneumonia. Imaging revealed a 10 cm lung mass, which was believed to be metastasis from the vulva. This was confirmed with biopsy and was completely resected. Any mass in the Bartholin gland area should be investigated carefully. Poorly differentiated vulvar leiomyosarcoma in the Bartholin gland can recur locally but may also lead to distant metastasis. Despite surgical and systemic treatment, as well as adjuvant radiation, the tumor recurred. Due to the rarity of this condition, there are no clear recommendations for

  17. Facial skin metastasis due to small-cell lung cancer: a case report

    Directory of Open Access Journals (Sweden)

    Barbetakis Nikolaos

    2009-01-01

    Full Text Available Abstract Introduction Cutaneous metastases in the facial region occur in less than 0.5% of patients with metastatic cancer. They are an important finding and are not often the first sign leading to diagnosis. Case presentation We describe the case of a 64-year-old male patient who presented with dyspnea, pleuritic pain, loss of weight and a nodule on his left cheek. A chest X-ray revealed a left upper lobe mass with mediastinal lymphadenopathy. Excision biopsy of the facial nodule revealed small-cell lung carcinoma. Palliative chemo-radiotherapy was administered and the patient survived for 12 months. Conclusion A high index of suspicion is necessary for the early detection of facial cutaneous metastases. Appropriate treatment may prolong patient survival.

  18. Traumatic Neuroma around the Celiac Trunk after Gastrectomy Mimicking a Nodal Metastasis: A Case Report

    OpenAIRE

    Kwon, Jung Hyeok; Ryu, Seung Wan; Kang, Yu Na

    2007-01-01

    Traumatic neuroma is a well-known disorder that occurs after trauma or surgery involving the peripheral nerve and develops from a nonneoplastic proliferation of the proximal end of a severed, partially transected, or injured nerve. We present a case of traumatic neuroma around the celiac trunk after gastrectomy in a 56-year-old man, which was confirmed by pathology. CT demonstrated the presence of a lobulated, homogeneous, hypoattenuating mass around the celiac trunk, mimicking a nodal metast...

  19. Single sternal metastasis due to malignant melanoma with unexpected long-term survival: a case report

    Science.gov (United States)

    Gogakos, Apostolos S; Paliouras, Dimitrios; Asteriou, Christos; Rallis, Thomas; Lazopoulos, Achilleas; Chatzinikolaou, Fotios; Zissimopoulos, Athanassios; Tsavlis, Drosos; Tsirgogianni, Katerina; Zarogoulidis, Konstantinos; Porpodis, Konstantinos; Tsakiridis, Kosmas; Pitsiou, Georgia; Kioumis, Ioannis; Karapantzos, Ilias; Karapantzou, Chrysanthi; Sachpekidis, Nikos; Zarogoulidis, Paul; Barbetakis, Nikolaos

    2016-01-01

    Metastases from melanoma have a very poor prognosis for the patient. Single metastatic lesions in the sternum due to melanoma are extremely rare. A rare case of a presternal mass in a 56-year-old patient who had undergone excision for malignant melanoma is presented. Review of the patient’s history and surgical resection of a single metastatic soft tissue lesion offer the best chance of long-term survival. PMID:26848270

  20. From aneurysmal bone cyst to telangiectatic osteosarcoma with metastasis in inguinal lymph nodes: Case report

    Directory of Open Access Journals (Sweden)

    Janevska Vesna

    2015-01-01

    Full Text Available Introduction. Aneurysmal bone cyst is a benign bone lesion composed of blood filled cystic cavities lined by fibrous septa. Its malignant transformation of is a rare event. Case report. We report a case of a lesion in the second metatarsal bone in a 29-year-old male, presented as a slight swelling of the right foot. After the curettage had been done, the diagnosis of aneurysmal bone cyst was made but the recurrence occurred 4 years later. The biopsy of the recurrent tumor showed compact neoplastic tissue consistent with diagnosis of giant cell tumor with malignancy. The malignant component was recognized as a high grade sarcoma with osteoid production. A tumor mass with the whole II metatarsal bone was extirpated and a resected part of fibula was transplanted. A year later, another recurrence occurred, an amputation was performed and a teleangiectatic osteosarcoma with ingvinal lymph nodes metastases was diagnosed. No other tumor mass was confirmed, either clinically or by imaging techniques at the time of his third operation. He died 4 months later with multiple pulmonary metastases. Conclusion. We emphasize the importance of team work in order to achieve the accurate diagnosis, highlighting careful radiological examinations, good sampling and awareness of unusual cases in bone tumor pathology.

  1. Persistent left superior vena cava mistaken for nodal metastasis: a case report

    Directory of Open Access Journals (Sweden)

    Papandrinopoulou Dimitra

    2010-06-01

    Full Text Available Abstract Introduction Evaluation of the mediastinum is crucial for patients with lung cancer. Mediastinal lymph node metastases play a dramatic role in the process of staging. Physicians should be aware of the potential pitfalls regarding mediastinal evaluation. This case report provides an example. Case presentation We report the case of a 57-year-old Caucasian man who presented with a four-month history of non-productive cough. He was diagnosed with non-small cell lung cancer. Initially, it was thought to be inoperable due to the presence of a para-aortic lymph node. A more careful examination of the mediastinum revealed that the "lymph node" was in fact a persistent left superior vena cava. Conclusions This study highlights the difficulties in mediastinal staging, especially when intravenous contrast is not used. The recognition of this vascular malformation dramatically changed the therapeutic decisions, giving our patient the opportunity of surgical resection. To the best of our knowledge, such correlation has not been described in English literature.

  2. Intra-cranial metastasis of gastrointestinal stromal tumor

    Institute of Scientific and Technical Information of China (English)

    WONG Chun-sing; CHU Yiu-ching

    2011-01-01

    With the evolution of immunochemical staining techniques and better imaging modalities with better image resolution and whole body coverage,gastrointestinal stromal tumor (GIST),the most common mesenchymal tumor of the gastrointestinal tract,is often encountered in clinical practice.Metastasis is common with malignant GIST and can be found in up to 50% of patients at presentation.Liver and peritoneum are the two most common sites of metastasis and accounted for 95% of cases.Lymphatics,bone and lung metastasis are rare.Malignant GIST with intracranial metastasis is even rarer,with only a few cases reported in the literature,and most of these had earlier metastasis elsewhere.Radiological features for GISTs are not specific but it does contribute to confirming early and accurate diagnosis of malignant GISTs by judging the tumor size,enhancement pattern and the invasion of adjacent structures.We report a case of a 26-year-old male with metastatic GIST to the liver and subsequently to the brain and skull vault.This is the first case reported in our locality and he is the youngest patient reported with this disease entity.The clinical progress,radiological features and the role of imaging will be discussed further in this paper.The radiological and clinical features of the primary tumor will specifically be addressed.The purpose of this paper is to enrich the current database of this rare disease entity and to alert both radiologists and clinicians about the imaging features of GIST with intracranial metastasis.

  3. Pemetrexed Combined with Cisplatin or Carboplatin Regimen in the Treatment of Advanced Recurrent or Metastasis Non-small Cell Lung Cancer: Analysis of 63 Cases

    Directory of Open Access Journals (Sweden)

    Wei WANG

    2011-01-01

    Full Text Available Background and objective Since the poor outcome for advanced lung cancer with first-line chemotherapy, more efforts should be paid for treatment of advanced recurrent or metastasis non-small cell lung cancer (NSCLC patients. Pemetrexed, as a multi-target antifolate chemotherapeutic drug, was approved for the second-line treatment of advanced NSCLC. The aim of this study is to evaluate the efficacy and side effects of pemetrexed combined with cisplatin/carboplatin in the treatment of advanced recurrent or metastasis NSCLC. Methods Sixty-three advanced recurrent or metastasis NSCLC patients confirmed with pathology or cytology were enrolled in this study. Among them, 40 cases were male and 23 were female, with 62 years of median age. The combination regimen was patients received pemetrexed 500 mg/m2 on day 1 and cisplatin 30 mg/m2 on day 1, day 2 and day 3 or carboplatin 300 mg/m2 on day 1 by intravenous infusion, with 21 days as one cycle. All patients who received 2 or more cycles could be evaluated. Results Only 1 case got complete response, with 5 cases partial response, 36 stable and 21 cases progressive. The overal control rate was 66.7% (42/63. The median survival time was 9.0 months, while the median progression-free survival was 5.0 months (3.0 months in squamous cell carcinoma; 5.5 months in adenocarcinoma. There was a significant difference between squamous cell carcinoma and adenocarcinoma (P=0.017. The common adverse effects were leucopenia, anemia and gastrointestinal response. Conclusion Pemetrexed combined with cisplatin/carboplatin is effective and feasible for advanced recurrent or metastasis NSCLC.

  4. Thyroid-Like Follicular Carcinoma of the Kidney in a Patient with Skull and Meningeal Metastasis: A Unique Case Report and Review of the Literature.

    Science.gov (United States)

    Dong, Liang; Huang, Jiayu; Huang, Luke; Shi, Oumin; Liu, Qiang; Chen, Haige; Xue, Wei; Huang, Yiran

    2016-04-01

    Thyroid-like follicular carcinoma of the kidney (TLFCK) is an extremely rare subtype of renal cell carcinoma with close resemblance to the well-differentiated thyroid follicular neoplasms. TLFCK has not been included in the 2004 World Health Organization (WHO) classification due to the limited data available. Only 27 cases have been reported in the literature to date. Herein, we report a unique case of TLFCK that presented as a striking skull and meningeal metastasis 5 years after the initial diagnosis; this is the first case of TLFCK with such a novel metastasis pattern. A 68-year-old woman was found to have a right renal lesion using computed tomography (CT) during her regular clinical follow-up visit for bladder cancer, but she exhibited no obvious clinical symptoms. The CT scan showed a 4.4-cm diameter, slightly lobulated soft tissue mass in the right lower kidney, the pathological findings of which showed a TLFCK. Five years later, the patient had progressed to skull and meningeal metastasis. Both the renal tumor and the metastasis lesion were composed almost entirely of follicles with a dense, colloid-like material that resembled thyroid follicular carcinoma. However, no lesion was found in the thyroid gland. The neoplastic epithelial cells were strongly immunoreactive for cytokeratin 7 (and vimentin but negative for thyroid transcription factor-1 and thyroglobulin. This is the first reported case of TLFCK to consist of widespread metastases to the skull and meninges and provides evidence that this rare variant of renal cell carcinoma has uncertain malignant potential and can be more clinically aggressive than previously believed. PMID:27082575

  5. Visual impairment due to bilateral multifocal choroidal metastasis of parotid adenocarcinoma: a case report.

    Directory of Open Access Journals (Sweden)

    Gerard eWalls

    2014-06-01

    Full Text Available BackgroundOrbital metastases are an uncommon finding, being present in just 9% deceased patients with metastatic cancer. Only a quarter of patients with choroidal metastases have bilateral disease. Parotid cancer is not a common form of head and neck malignancy. Bilateral multifocal metastases from adenocarcinoma ex pleomorphic of parotid gland have been documented just once before in the literature. We present a similar case where palliative EBRT was used to gain local control with minimal toxicity.Case PresentationThe case of a 45 year old Caucasian gentleman who presented to his general practitioner with otalgia and weight loss. Imaging revealed a mass in the deep lobe of the left parotid gland, invading into the medial pterygoid muscle. PET-CT revealed locoregional and distant lymphatic involvement plus disseminated skeletal metastases. Lymph node examination revealed adenocarcinoma ex pleomorphic histology. Within weeks of this diagnosis, the patient developed rapidly progressive visual impairment. Ophthalmologists found multifocal uveal masses bilaterally. Palliative fractions of external beam radiotherapy were delivered to the orbits before combination chemotherapy. We discuss the patient's presentation, histopathology and management, with support from the literature regarding applied and related therapies. SummaryIn this rare presentation of disseminated malignancy affecting the choroid bilaterally, the authors demonstrate the application of palliative EBRT to good local effect. Given the nature of this treatment and that of the metastases, in the setting of incurable disease orbital morbidity is likely to occur again before the patient's death. Awareness of the initial symptoms is important to provide prompt care and maintain quality of life.

  6. Ovarian teratoma mimicking metastasis on I-131 scan : a case report.

    Science.gov (United States)

    Yoon, Sohee; Soo Hong, In

    2013-03-01

    The whole body I-131 scan is routinely performed in the postoperative treatment of patients with well-differentiated thyroid cancer. Accurate interpretation of whole body I-131 scan after thyroidectomy is critical to appropriate management of patients with thyroid cancer, to prevent unnecessary surgical removal or exposure to radioiodine. Unfortunately, false-positive uptakes in several other organs and their associated disease processes have been reported. We report a case of false-positive iodine uptake in the pelvic region with incidentally diagnosed mature cystic teratoma. PMID:24895508

  7. Ovarian teratoma mimicking metastasis on I 131 Scan: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Sohee; Hong, Insoo [Yonsei Univ. Wonju College of Medicine, Wonju (Korea, Republic of)

    2012-03-15

    The whole body I 131 scan is routinely performed in the postoperative treatment of patients with well differentiated thyroid cancer. Accurate interpretation of whole body I 131 scan after thyroidectomy is critical to appropriate management of patients with thyroid cancer, to prevent unnecessary surgical removal or exposure to radioiodine. Unfortunately, false positive uptakes in several other organs and their associated disease processes have been reported. We report a case of false positive iodine uptake in the pelvic region with incidentally diagnosed mature cystic teratoma.

  8. Renal metastasis from cervical carcinoma presenting as a renal cyst: A case report

    OpenAIRE

    FAN, GANG; Xie, Yu; PEI, XIAMING; Lei, Jian; YE, MINGJI; ZENG, GONGQIAN; LI, FEIPING; XIONG, YINGYING; HAN, WEIQIN

    2015-01-01

    In the present study, the case of a 51-year-old female with a metastatic tumor in the left kidney originating from cervical carcinoma, is reported. The patient had undergone chemoradiotherapy for stage IIB squamous-cell carcinoma of the uterine cervix 3 years earlier. Computed tomography (CT) identified low-density left renal nodules, which were diagnosed post-operatively as renal cysts during the follow-up conducted 2 years later. The next year, the patient was admitted to the Hunan Provinci...

  9. Small primary adenocarcinoma in adenomyosis with nodal metastasis: a case report

    Directory of Open Access Journals (Sweden)

    Campagnutta Elio

    2007-06-01

    Full Text Available Abstract Background Malignant transformation of adenomyosis is a very rare event. Only about 30 cases of this occurrence have been documented till now. Case presentation The patient was a 57-year-old woman with a slightly enlarged uterus, who underwent total hysterectomy and unilateral adnexectomy. On gross inspection, the uterine wall displayed a single nodule measuring 5 cm and several small gelatinous lesions. Microscopic examination revealed a common leiomyoma and multiple adenomyotic foci. A few of these glands were transformed into a moderately differentiated adenocarcinoma. The endometrium was completely examined and tumor free. The carcinoma was, therefore, considered to be an endometrioid adenocarcinoma arising from adenomyosis. Four months later, an ultrasound scan revealed enlarged pelvic lymph nodes: a cytological diagnosis of metastatic adenocarcinoma was made. Immunohistochemical studies showed an enhanced positivity of the tumor site together with the neighbouring adenomyotic foci for estrogen receptors, aromatase, p53 and COX-2 expression when compared to the distant adenomyotic glands and the endometrium. We therefore postulate that the neoplastic transformation of adenomyosis implies an early carcinogenic event involving p53 and COX-2; further tumor growth is sustained by an autocrine-paracrine loop, based on a modulation of hormone receptors as well as aromatase and COX-2 local expression. Conclusion Adenocarcinoma in adenomyosis may be affected by local hormonal influence and, despite its small size, may metastasize.

  10. Pancreatic metastasis of Merkel cell carcinoma and concomitant insulinoma: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Hartschuh Wolfgang

    2005-09-01

    Full Text Available Abstract Background Merkel cell carcinomas are rare neoplasm of neuroendocrine origin, usually observed in elderly people in areas with abundant sunlight, and predominantly located on the head and neck, extremities, and trunk. In many patients, a local recurrence after resection of the primary tumour and even distant metastases can be found. Case presentation We report an unusual occurrence of pancreatic metastases from a previously diagnosed Merkel cell carcinoma with the discovery of a concomitant insulinoma. An 82-year old lady suffered from recurrent attacks of hypoglycemia and presented with an abdominal mass, 2 years prior she had an excision done on her eyebrow that was reported as Merkel cell carcinoma. An extended distal pancreatectomy and splenectomy along with resection of the left flexure of the colon for her abdominal mass was carried out. Final histopathology of the mass was a poorly differentiated endocrine carcinoma in the pancreatic tail, in the peripancreatic tissue and in the surrounding soft tissue consistent with metastatic Merkel cell carcinoma in addition to an insulinoma of the pancreatic body. Conclusion This is the first documented case of a metastatic Merkel cell carcinoma and a concomitant insulinoma, suggesting either a mere coincidence or an unknown neuroendocrine tumor syndrome.

  11. Cutaneous metastasis in anorectal adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Krishnendra Varma

    2015-01-01

    Full Text Available Cutaneous metastasis in anorectal adenocarcinoma is a rare entity. Here, we report the case of a 40-year-old female who presented with yellowish-brown, irregular, solid, elevated rashes over the pubis with a recent history off palliative colostomy for anorectal adenocarcinoma. Clinically, we suspected metastasis that was proved on biopsy. We report this case due to the rare presenting site (i.e., perineum of a metastatic adenocarcinoma.

  12. Toward determining the lifetime occurrence of metastatic brain tumors estimated from 2007 United States cancer incidence data

    OpenAIRE

    Davis, Faith G; Dolecek, Therese A.; McCarthy, Bridget J.; Villano, John L.

    2012-01-01

    Few population estimates of brain metastasis in the United States are available, prompting this study. Our objective was to estimate the expected number of metastatic brain tumors that would subsequently develop among incident cancer cases for 1 diagnosis year in the United States. Incidence proportions for primary cancer sites known to develop brain metastasis were applied to United States cancer incidence data for 2007 that were retrieved from accessible data sets through Centers for Diseas...

  13. Current Concepts of Metastasis Formation

    Directory of Open Access Journals (Sweden)

    Peter Gassman

    2011-07-01

    Full Text Available The development of secondary distant organ and lymph node metastasis has an extraordinary impact on the prognosis of patients with solid cancer. In most cases the advent of metastatic growth represents the turning point from a local, potentially curable, disease to a systemic non-curable situation. As a highly regulated process, metastasis formation follows a distinct, non-random pattern characteristic for each tumor entity. Metastasis formation and strategies to prevent this lethal event in the progression of cancer is of fundamental interest for cancer science and patient care. In this special issue of Cancers, papers highlighting cellular mechanisms of metastasis formation, genetic and epigenetic aspects associated with organ and tumor specific metastasis formation, as well as papers outlining experimental and clinical therapeutic concepts for anti-metastatic treatment are included.

  14. Tibial bone metastasis as an initial presentation of endometrial carcinoma diagnosed by fine-needle aspiration cytology: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Sarag Aboujafar Boukhar

    2015-01-01

    Full Text Available Endometrial cancer is the most common gynecologic malignancy in the United States. However, bony metastasis is infrequent and exceptionally rare as the initial presentation. We report a case of a 77-year-old female with a clinically silent endometrial carcinoma who presented with a left tibial metastasis as the first manifestation of her disease. Ours is only the third case diagnosed by fine-needle aspiration (FNA cytology, and the first to detail the cytomorphologic features of metastatic endometrial cancer to bone. These microscopic findings, including three-dimensional cohesive clusters with cellular overlapping and cuboidal to columnar cells exhibiting low nuclear: cytoplasmic ratios and partially vacuolated cytoplasm, differ significantly from those of endometrial carcinoma on a Papanicolaou test. The tumor bore similarity to the more commonly encountered metastatic colon cancer, but immunohistochemical staining enabled reliable distinction between these entities. A review of osseous metastases of endometrial cancer demonstrates a predilection for bones of the lower extremity and pelvis with a predominance of the endometrioid histologic subtype. In about a quarter of the cases, the bony metastasis was the first manifestation of the cancer. FNA was an effective diagnostic modality for this unusual presentation of a common malignancy. Awareness of this entity and its differential diagnosis is essential for accurate and timely diagnosis.

  15. Serial Pancreas, Liver and Duodenal Metastasis from Renal Clear Cell Cancer: a Case Report

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    @@ Case Report In August 2004, a 76-year-old patient was referred to our hospital for progressive loss of appetite, accompanied with mild upper abdominal distention, pain, hiccups and dyspepsia over a recent 3 months period. Reviewing his disease history showed that 16 months before admission (April 2003), he was diagnosed with a recurring left renal clear cell cancer (immunohistochemical staining of tumor cells were positive for CK and Vim, but negative for SMA, HMB-45 and HHF-35, Fig. 1) 10 years after a nephrectomy due to a right renal cancer. At that time, he was treated with photodynamic therapy followed by bio-immunotherapy(interleukine-2 plus lymphokine-activated killer cells). Follow-up by an abdominal CT scan every 3 months showed significant regression of the left renal carcinoma.

  16. MRI findings of lumbosacral metastasis from occult follicular thyroid cancer: report of a case.

    Science.gov (United States)

    Çoban, Gökçen; Yildirim, Erkan; Gemici, Kazim; Erinanç, Hilal

    2014-03-01

    A 63-year-old female was admitted to our hospital with bowel and bladder incontinence. Magnetic resonance imaging (MRI) showed a 13 × 12 × 12 cm mass invading the posterior regions of the L4, L5, S1 and S2 vertebrae with broad paravertebral soft tissue invasion. A Tru-cut biopsy of the mass was performed. The histopathological examination revealed metastatic follicular carcinoma of the thyroid. Thyroid functional tests were within the normal limits. Thyroid sonography revealed a heterogeneous, ill-defined, 14 × 9 mm hypoechoic solid nodule in the right lobe of the thyroid gland. On thyroid scintigraphy, an area of focal hyperactivity was detected in the right lobe at the nodule localization. Total thyroidectomy was performed, and the primary tumor pathology was determined to be follicular thyroid cancer. To our knowledge, only a few cases of lumbosacral cord compression as the initial manifestation of follicular thyroid carcinoma have been reported in the literature. We aimed to discuss the MRI findings of tumors in this age group with lumbosacral localization. PMID:23129029

  17. Small primary adenocarcinoma in adenomyosis with nodal metastasis: a case report

    International Nuclear Information System (INIS)

    Malignant transformation of adenomyosis is a very rare event. Only about 30 cases of this occurrence have been documented till now. The patient was a 57-year-old woman with a slightly enlarged uterus, who underwent total hysterectomy and unilateral adnexectomy. On gross inspection, the uterine wall displayed a single nodule measuring 5 cm and several small gelatinous lesions. Microscopic examination revealed a common leiomyoma and multiple adenomyotic foci. A few of these glands were transformed into a moderately differentiated adenocarcinoma. The endometrium was completely examined and tumor free. The carcinoma was, therefore, considered to be an endometrioid adenocarcinoma arising from adenomyosis. Four months later, an ultrasound scan revealed enlarged pelvic lymph nodes: a cytological diagnosis of metastatic adenocarcinoma was made. Immunohistochemical studies showed an enhanced positivity of the tumor site together with the neighbouring adenomyotic foci for estrogen receptors, aromatase, p53 and COX-2 expression when compared to the distant adenomyotic glands and the endometrium. We therefore postulate that the neoplastic transformation of adenomyosis implies an early carcinogenic event involving p53 and COX-2; further tumor growth is sustained by an autocrine-paracrine loop, based on a modulation of hormone receptors as well as aromatase and COX-2 local expression. Adenocarcinoma in adenomyosis may be affected by local hormonal influence and, despite its small size, may metastasize

  18. Anal metastasis as the sentinel and isolated presentation of invasive ductal breast carcinoma.

    Science.gov (United States)

    Rengifo, C; Titi, S; Walls, J

    2016-05-01

    Breast cancer currently affects 1 in 8 women in the UK during their lifetime. Common sites for breast cancer metastasis include the axillary lymph nodes, bones, lung, liver, brain, soft tissue and adrenal glands. There is well documented evidence detailing breast metastasis to the gastrointestinal tract but anal metastasis is exceptionally rare. We present the case of a 78-year-old woman with an anal metastasis as the sentinel and isolated presentation of an invasive ductal breast carcinoma. As advances in the treatment of breast cancer improve, and with an ageing and expanding population, there will be an increasing number of cancer survivors, and more of these unusual presentations may be encountered in the future. PMID:27087339

  19. OVARIAN METASTASIS IN PATIENT WITH ENDOMETRIAL CARCINOMA

    Institute of Scientific and Technical Information of China (English)

    ZHOU Feng-zhi; CHEN Yi-nan; ZHANG Guo-nan

    2005-01-01

    Objective: To study the clinical pathological characteristics of ovarian metastasis of endometrial carcinoma and the factors affecting prognosis. Methods: Retrospective analysis was made to the clinical pathological outcome of endometrial carcinoma patients receiving surgical treatment in our hospital from January 1990 to December 2002. Results:Among the 191 cases of endometrial carcinoma patients, 17 cases (8.9%) had ovarian metastasis and young patients were more likely to have ovarian metastasis. The multiple factor analysis showed that the independent risk factors of ovarian metastasis in endometrial carcinoma included the depth of myometrial invasion, lymph node metastasis and pathological types. Conclusion: Ovarian metastasis in patients with endometrial carcinoma is associated with poor prognosis, the depth of myometrial invasion, lymph node metastasis and histologic types are independent risk factors affecting the prognosis. For young patients at early stage of the disease, it should be prudent as to whether to retain the ovary.

  20. [Efficacy of UFT in the treatment of para-aortic lymph node metastasis following gastric cancer surgery: case report].

    Science.gov (United States)

    Ishikawa, T; Matsusaka, T; Wakasugi, K; Tashiro, H; Yanaga, K; Yamamura, S; Sonoda, K; Kume, K

    2000-05-01

    The patient was a 68-year-old man who underwent pyloric gastrectomy for advanced stomach cancer on December 6, 1996. The histopathological diagnosis was poorly differentiated adenocarcinoma, ss, ly3, v1, n2 (+), and stage IIIa. Postoperative adjuvant chemotherapy consisted of short-term intravenous infusion of 5-FU, 320 mg/m2/day (= 480 mg/body) for 5 days beginning on postoperative day (POD) 1, and oral 5-FU, 200 mg/day, for 1 year beginning on POD 14. The preoperative CEA value was 316.2 ng, but it fluctuated below 10 ng postoperatively. About one year after the operation, the patient began to complain of epigastric pain, loss of appetite, and general malaise. CT of the upper abdomen revealed a 1.5-cm para-aortic lymph node, and the CEA value of 319.0 ng was abnormally high. 5-FU was stopped, oral UFT at 300 mg/day was started, and the patient's course was followed. Three months after the start of UFT, the lymph node had shrunk on CT (shrinkage rate: 66.7%), and the CEA value had decreased to 14.3 ng. As though corresponding to these changes there was a gradual decrease in the epigastric pain, general malaise, etc., and the patient's appetite also returned. There were no subsequent elevations in the CEA values or increases in the size of the para-aortic lymph nodes, and the patient's general condition was favorably maintained. UFT appeared to be effective against the lymph node metastasis around the aorta in this case. PMID:10832445

  1. Metastasis Suppressor Genes

    OpenAIRE

    Yan, Jinchun; Yang, Qin; Huang, Qihong

    2013-01-01

    Metastasis is a major cause of cancer mortality. Metastasis is a complex process that requires the regulation of both metastasis-promoting and metastasis suppressor genes. The discovery of metastasis suppressor genes contributes significantly to our understanding of metastasis mechanisms and provides prognostic markers and therapeutic targets in clinical cancer management. In this review, we summarize the methods that have been used to identify metastasis suppressors and the potential clinica...

  2. Rare case of trilateral retinoblastoma with spinal canal drop metastasis detected with fluorine-18 fluorodeoxyglucose positronemission tomography/computed tomography imaging

    International Nuclear Information System (INIS)

    Trilateral retinoblastoma (TRb) is a rare syndrome associating hereditary bilateral or unilateral retinoblastoma (Rb) with an intracranial neuroblastic tumor. The latter arises in the midline, most often in the pineal gland, less frequently in the suprasellar or parasellar region. The outcome is usually fatal because of secondary spinal dissemination. We report 10-year-old boy presented with a right eye proptosis and leukocoria, and the magnetic resonance imaging (MRI) showed right orbital mass lesion infiltrating optic nerve and diagnosis of retinoblastoma was made. He was referred for fluorodeoxyglucose-positron emission tomography/computed tomography (FDG PET/CT) to find out the extent of the disease. PET/CT showed abnormal FDG-uptake within right orbital mass lesion, suprasellar enhancing lesion and drop metastasis in the cervical spinal canal level. He was diagnosed as a case of TRb with spinal canal drop metastasis. He underwent chemotherapy and craniospinal irradiation

  3. Clinicopathological features and treatment of extremity bone metastasis in patients with endometrial carcinoma: a case report and review

    Institute of Scientific and Technical Information of China (English)

    JIANG Guo-qing; GAO Yu-nong; GAO Min; ZHENG Hong; YAN Xin; WANG Wen; AN Na; CAO Kun

    2011-01-01

    Unlike other non-gynecologic solid tumors, such as breast cancer, lung cancer, metastasis to bone from endometrial carcinoma is rare, metastasis to extremity is extremely rare. We report a 51-year-old multiparous woman with FIGO Stage IVb Grade 2 endometrial adenocarcinoma which metastasized to left lower extremity bone. She received an amputation of left lower extremity below the knees, and a total abdominal hysterectomy and bilateral salpingo-oophorectomy, and followed by systemic chemotherapy, radiation therapy to the pelvis and progestational agent. She had a complete response to above treatments, and disease-free survival for 10 months. After recurrence, she received chemotherapy, radiotherapy and progestational agent once again. She had lived 56 months and is still alive by the time of report. Metastasis of endometrial carcinoma to extremity bone can rarely occur and should be considered when the patient with endometrial carcinoma complained of unexplained pain and swelling associated with extremity bone.

  4. Supratentorial metastasis of medulloblastoma in adults.

    Science.gov (United States)

    Kumar, Sushil; Handa, Amit; Jha, Deepak K; Choudhary, Ajay

    2016-01-01

    Two adults, 31 and 20 years of age, developed supratentorial metastasis 3½ years and 11 months, respectively, after gross total removal of their posterior fossa medulloblastoma. The first case developed spinal metastasis as well. Both had undergone craniospinal irradiation. Case 1 underwent laminectomy and case 2 underwent craniotomy because their presenting symptoms required so. PMID:27366282

  5. A case of odontogenic brain abscess arising from covert dental sepsis

    OpenAIRE

    Clifton, TC; Kalamchi, S

    2011-01-01

    Odontogenic infections can spread to any organ of the body and in some cases cause life threatening infections. We report a case of multiple odontogenic brain abscesses resulting from undetected tooth decay. Whereas most odontogenic brain abscesses occur following dental treatment, this report documents brain abscesses prior to dental treatment, signifying the dangers of covert dental infections. This case report updates the literature on the topic of odontogenic brain abscesses.

  6. Brain Abscess after Transanal Hemorrhoidal Dearterialization: A Case Report

    Directory of Open Access Journals (Sweden)

    A.E.M. Berkel

    2013-05-01

    Full Text Available A relatively new therapy in the treatment of hemorrhoids is transanal hemorrhoidal dearterialization (THD. We report a case of brain abscess caused by Streptococcus milleri following THD. Although a brain abscess after drainage of a perianal abscess has been described in the literature, no report exists of a brain abscess following treatment of hemorrhoids. A healthy 51-year-old man with hemorrhoids underwent THD. Two weeks later he presented with a headache, bradyphrenia, flattened behavior and a left hemiplegia. No perianal complaint and/or perianal abscess was present. A contrast CT scan of the cerebrum showed a right temporoparieto-occipital abscess, with edema and compression of the surrounding tissue and lateral ventricles. MRI showed an abscess with leakage in the right lateral ventricle. Treatment with dexamethasone and intravenous antibiotics was started. Because of progression of symptoms, 3 weeks later ventriculoscopy was performed and the abscess was drained. Culture of the punctuate showed S. milleri. Because of developing hydrocephalus 3 days after ventriculoscopy, first an external ventricle drain and later a ventriculoperitoneal drain was placed. Hereafter the hemiplegia and cognitive disorders improved. This case report describes a severe complication following treatment of hemorrhoids with THD which until now, to our knowledge, has never been described in the literature.

  7. Assessment of serum L-fucose in brain tumor cases

    Directory of Open Access Journals (Sweden)

    Manjula S

    2010-01-01

    Full Text Available Background: Glycosylation of altered tumor cell in relation to cellular heterogeneity in human intracranial tumors remains relatively unexposed. Serum protein-bound carbohydrate, L-Fucose is reported to be overexpressed during tumor progression by many investigators. Therefore, there is a need to determine the diagnostic, prognostic, functional significance of glycoprotein elevations in various cases of tumors. Objective: The objective of the present study was to evaluate the clinical utility of serum L-fucose in patients with brain tumor. Materials and Methods: Serum glyco-conjugate levels were estimated in 99 patients with brain tumors. Estimation of L-fucose was carried out colorimetrically by the method of Winzler using cysteine hydrochloride. Results: There was a significant increase in L-fucose level in most of the patients. In the posttreatment cases, the L-fucose levels were apparently low compared to preoperative values. Conclusion: Our results showed that the rise in serum L-fucose may be used as a general marker for brain tumors in addition to other markers.

  8. [Concurrent association of reirradiation therapy with everolimus for lymph node metastasis of gastroesophageal junction cancer: a case report].

    Science.gov (United States)

    Pernin, V; Beuzeboc, P; Peurien, D; Louvet, C; Kirova, Y

    2014-11-01

    Advanced gastric cancer or gastro-oesophageal junction cancer after a failure of first line chemotherapy have poor outcome. Hereby, we present the first patient treated by radiotherapy with concurrent everolimus, a mTor inhibitor, for a reirradiation of metastasis invading left axillary, infraclavicular and supraclavicular lymph nodes in progression despite several lines of chemotherapy. After 6 months of follow-up, this association provided a satisfactory anti-tumor efficiency and tolerance. Nevertheless, clinical trials are needed in order to confirm this strategy for the treatment of gastric cancer metastasis. PMID:24981410

  9. Surgery with radioguided location of a liver metastasis of melanoma choroid: case report; Cirurgia com localizacao radioguiada de uma metastase hepatica de melanoma de coroide: relato de caso

    Energy Technology Data Exchange (ETDEWEB)

    Moreno, Marcelo; Miranda, Mario Henrique Furlanetto, E-mail: mmoreno@unochapeco.edu.br, E-mail: mirandamario@unochapeco.edu.br [Universidade Comunitaria da Regiao de Chapeco (UNOCHAPECO), SC (Brazil)

    2015-04-15

    Introduction: The use of radioguided occult lesion localization prior to surgical excision is increasing, mainly due to the development of new probes and the use of PET-CT. Case report: A 70-year-old male who presented with a metastatic lesion in his liver from a choroidal melanoma. This was located using PET-CT and subsequently located with a low-energy intraoperative gamma probe during the laparotomy. Conclusion: The present case shows that it is possible to excise a hepatic metastasis utilizing the principles of radioguided surgery, even in centers without access to high energy probes. (author)

  10. Affective psychosis, Hashimoto's thyroiditis, and brain perfusion abnormalities: case report

    Directory of Open Access Journals (Sweden)

    Loviselli Andrea

    2007-12-01

    Full Text Available Abstract Background It has recently become evident that circulating thyroid antibodies are found in excess among patients suffering from mood disorders. Moreover, a manic episode associated with Hashimoto's thyroiditis has recently been reported as the first case of bipolar disorder due to Hashimoto's encephalopathy. We report a case in which Hashimoto's thyroiditis was suspected to be involved in the deteriorating course of mood disorder and discuss potential pathogenic mechanisms linking thyroid autoimmunity with psychopathology. Case presentation A 43-year-old woman, with a history of recurrent depression since the age of 31, developed manic, psychotic, and soft neurological symptoms across the last three years in concomitance with her first diagnosis of Hashimoto's thyroiditis. The patient underwent a thorough medical and neurological workup. Circulating thyroperoxidase antibodies were highly elevated but thyroid function was adequately maintained with L-thyroxine substitution. EEG was normal and no other signs of current CNS inflammation were evidenced. However, brain magnetic resonance imaging evidenced several non-active lesions in the white matter from both hemispheres, suggestive of a non-specific past vasculitis. Brain single-photon emission computed tomography showed cortical perfusion asymmetry particularly between frontal lobes. Conclusion We hypothesize that abnormalities in cortical perfusion might represent a pathogenic link between thyroid autoimmunity and mood disorders, and that the rare cases of severe Hashimoto's encephalopathy presenting with mood disorder might be only the tip of an iceberg.

  11. Solitary pulmonary metastasis from prostate sarcomatoid cancer

    OpenAIRE

    Oyamada Yoshitaka; Maeshima Arafumi; Goto Taichiro; Kato Ryoichi

    2010-01-01

    Abstract Background Pulmonary metastasis from prostate cancer is considered to be a late event, and patients can be treated with chemotherapy or hormonal manipulation. However, there has been only a few reports on surgical resection for pulmonary metastasis from prostate cancer. Case Presentation We present a surgical case of solitary pulmonary metastasis from prostate cancer. A 73-year-old man underwent pelvic evisceration for prostate cancer. Histopathological examination revealed a poorly ...

  12. Endobronchial metastasis in breast cancer.

    OpenAIRE

    Albertini, R E; Ekberg, N L

    1980-01-01

    Ten patients with endobronchial metastasis from primary breast cancer were found among 1200 fibreoptic bronchoscopies. Six of these patients had radiological signs suggesting bronchial obstruction. The diagnosis was verified in nine cases by means of bronchoscopic biopsy or cytology and in one by thoracotomy. Endobronchial metastasis should be considered when symptoms or chest films suggest endobronchial disease in a patient with a history of breast cancer.

  13. Definitive Chemoradiation Therapy Following Surgical Resection or Radiosurgery Plus Whole-Brain Radiation Therapy in Non-Small Cell Lung Cancer Patients With Synchronous Solitary Brain Metastasis: A Curative Approach

    Energy Technology Data Exchange (ETDEWEB)

    Parlak, Cem, E-mail: cemparlak@gmail.com [Department of Radiation Oncology, Baskent University, Adana Medical Faculty, Adana (Turkey); Mertsoylu, Hüseyin [Department of Medical Oncology, Baskent University, Adana Medical Faculty, Adana (Turkey); Güler, Ozan Cem; Onal, Cem; Topkan, Erkan [Department of Radiation Oncology, Baskent University, Adana Medical Faculty, Adana (Turkey)

    2014-03-15

    Purpose/Objectives: The aim of this study was to evaluate the impact of definitive thoracic chemoradiation therapy following surgery or stereotactic radiosurgery (SRS) and whole-brain radiation therapy (WBRT) on the outcomes of patients with non-small cell lung cancer (NSCLC) with synchronous solitary brain metastasis (SSBM). Methods and Materials: A total of 63 NSCLC patients with SSBM were retrospectively evaluated. Patients were staged using positron emission tomography-computed tomography in addition to conventional staging tools. Thoracic radiation therapy (TRT) with a total dose of 66 Gy in 2 Gy fractions was delivered along with 2 cycles of cisplatin-based chemotherapy following either surgery plus 30 Gy of WBRT (n=33) or SRS plus 30 Gy of WBRT (n=30) for BM. Results: Overall, the treatment was well tolerated. All patients received planned TRT, and 57 patients (90.5%) were also able to receive 2 cycles of chemotherapy. At a median follow-up of 25.3 months (7.1-52.1 months), the median months of overall, locoregional progression-free, neurological progression-free, and progression-free survival were 28.6, 17.7, 26.4, and 14.6, respectively. Both univariate and multivariate analyses revealed that patients with a T1-T2 thoracic disease burden (P=.001), a nodal stage of N0-N1 (P=.003), and no weight loss (P=.008) exhibited superior survival. Conclusions: In the present series, surgical and radiosurgical treatments directed toward SSBM in NSCLC patients were equally effective. The similarities between the present survival outcomes and those reported in other studies for locally advanced NSCLC patients indicate the potentially curative role of definitive chemoradiation therapy for highly selected patients with SSBM.

  14. Definitive Chemoradiation Therapy Following Surgical Resection or Radiosurgery Plus Whole-Brain Radiation Therapy in Non-Small Cell Lung Cancer Patients With Synchronous Solitary Brain Metastasis: A Curative Approach

    International Nuclear Information System (INIS)

    Purpose/Objectives: The aim of this study was to evaluate the impact of definitive thoracic chemoradiation therapy following surgery or stereotactic radiosurgery (SRS) and whole-brain radiation therapy (WBRT) on the outcomes of patients with non-small cell lung cancer (NSCLC) with synchronous solitary brain metastasis (SSBM). Methods and Materials: A total of 63 NSCLC patients with SSBM were retrospectively evaluated. Patients were staged using positron emission tomography-computed tomography in addition to conventional staging tools. Thoracic radiation therapy (TRT) with a total dose of 66 Gy in 2 Gy fractions was delivered along with 2 cycles of cisplatin-based chemotherapy following either surgery plus 30 Gy of WBRT (n=33) or SRS plus 30 Gy of WBRT (n=30) for BM. Results: Overall, the treatment was well tolerated. All patients received planned TRT, and 57 patients (90.5%) were also able to receive 2 cycles of chemotherapy. At a median follow-up of 25.3 months (7.1-52.1 months), the median months of overall, locoregional progression-free, neurological progression-free, and progression-free survival were 28.6, 17.7, 26.4, and 14.6, respectively. Both univariate and multivariate analyses revealed that patients with a T1-T2 thoracic disease burden (P=.001), a nodal stage of N0-N1 (P=.003), and no weight loss (P=.008) exhibited superior survival. Conclusions: In the present series, surgical and radiosurgical treatments directed toward SSBM in NSCLC patients were equally effective. The similarities between the present survival outcomes and those reported in other studies for locally advanced NSCLC patients indicate the potentially curative role of definitive chemoradiation therapy for highly selected patients with SSBM

  15. Rare case of axillary lymph node metastasis in papillary thyroid carcinoma detected using Iodine-131 whole-body scintigraphy and single-photon emission computed tomography/computed tomography

    International Nuclear Information System (INIS)

    Differentiated thyroid cancer is, usually, associated with an excellent prognosis and indolent course. Distant metastases are rare events at the onset of thyroid cancer. Among these presentations, metastasis to the axillary lymph nodes is even more unusual. Only few cases of papillary carcinoma with axillary nodal metastasis were previously reported in the literature. We present a 38-year-old female who underwent Iodine-131 whole-body scintigraphy, after total thyroidectomy and bilateral neck lymph node dissection for papillary carcinoma of thyroid, showed intense uptake in the remnant thyroid, lung metastasis, left cervical and left axillary lymph nodes. Excision of left axillary lymph nodes confirmed metastatic papillary carcinoma

  16. [Leptomeningeal Dissemination in Patients with Pituitary Metastasis from Breast Cancer].

    Science.gov (United States)

    Hayashi, Nakamasa; Mitsuya, Koichi; Harada, Hideyuki; Watanabe, Junichiro; Nishimura, Tetsuo; Nakasu, Yoko

    2016-05-01

    Pituitary metastases are uncommon complications of systemic cancer and account for only 1% of pituitary lesions. Breast cancer is one of the most common tumors to metastasize to the pituitary gland. A multidisciplinary approach that calls for close collaboration among oncologists, neurosurgeons, radiologists, and endocrinologists is mandatory for diagnosis and treatment of pituitary metastasis. From 2002 through 2013, 6 patients with pituitary metastases were treated at Shizuoka Cancer Center Hospital. The patients' age at presentation ranged from 45 to 75 years(average 59 years). Five of 6 patients had symptoms: anterior pituitary insufficiency in 4, diabetes insipidus in 3, and visual deficits in 2 patients. Five patients had other metastases at the time of presentation. Local irradiation to the metastatic lesion was adopted in 4, and whole brain irradiation was in 2 patients. In all cases, local control was achieved after irradiation, however, the pituitary insufficiency did not recover. Two of 4 patients treated with local irradiation suffered from meningeal dissemination within 5 months after treatment, and died at 8 and 11 months after diagnosis of pituitary metastasis, respectively. The patients treated with whole brain irradiation had longer survival periods. Early diagnosis, endocrinological management, and radiation therapy improve the quality of life in patients suffering from pituitary metastasis. Whole brain irradiation may be favorable in order to prevent meningeal dissemination. PMID:27166841

  17. CT evaluation of choriocarcinoma with brain metastases

    International Nuclear Information System (INIS)

    It is well established that the computed tomography(CT) is an essential part not only in screening primary brain tumors, but also in staging known malignancy. This paper reports various CT findings demonstrated in 12 cases of choriocarcinoma with brain metastasis. The CT findings such as the number, location and density of the metastatic lesions, the degree of brain edema, mass effect and effect of contrast enhancement are reviewed as well as the episode of stroke syndrome and survival duration after neurologic symptom attacks. The results were as follows: 1. The of these cases showed solitary metastatic lesion and remaining 2 cases were multiple lesions. 2. One was isodense density and the others were hemorrhagic increased density by CT. 3. All of these showed mass effect to the surrounding structures along with moderate to marked brain edema. 4. The position of the metastatic lesion were located at the supratentorially in all cases. Most of them were at the unilateral frontal or parietal area or both of them. One which noted multiple metastatic foci showed at the bilateral occipital regions. 5. Nine cases showed ring enhancement after contrast infusion. One which noted isodense density on the noninfusion scan showed also ring enhancement after contrast infusion. 6. Nine cases showed positive stroke syndrome. One of them was performed emergency craniotomy. The remaining 3 cases noted progressive neurologic symptoms. 7. Two cases were noted only brain metastasis but the others also had various degree of pulmonary metastasis and 2 of latter had hepatic metastasis, too. 8. Most of the cases were treated with CHAMOCA regimen, and one of them was taken whole brain irradiation (3000 rads/2 weeks). Another on case revealed marked regression of not only metastatic brain lesion but the pulmonary lesion after the 8th course of CHAMOCA regimen and still alive for over 460 days

  18. CT evaluation of choriocarcinoma with brain metastases

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Sei Chul; Kim, Choon Yul; Kwon, Hyung Chul; Bahk, Young Whee; Kim, Seung Jo [Catholic Medical College, Seoul (Korea, Republic of)

    1984-03-15

    It is well established that the computed tomography(CT) is an essential part not only in screening primary brain tumors, but also in staging known malignancy. This paper reports various CT findings demonstrated in 12 cases of choriocarcinoma with brain metastasis. The CT findings such as the number, location and density of the metastatic lesions, the degree of brain edema, mass effect and effect of contrast enhancement are reviewed as well as the episode of stroke syndrome and survival duration after neurologic symptom attacks. The results were as follows: 1. The of these cases showed solitary metastatic lesion and remaining 2 cases were multiple lesions. 2. One was isodense density and the others were hemorrhagic increased density by CT. 3. All of these showed mass effect to the surrounding structures along with moderate to marked brain edema. 4. The position of the metastatic lesion were located at the supratentorially in all cases. Most of them were at the unilateral frontal or parietal area or both of them. One which noted multiple metastatic foci showed at the bilateral occipital regions. 5. Nine cases showed ring enhancement after contrast infusion. One which noted isodense density on the noninfusion scan showed also ring enhancement after contrast infusion. 6. Nine cases showed positive stroke syndrome. One of them was performed emergency craniotomy. The remaining 3 cases noted progressive neurologic symptoms. 7. Two cases were noted only brain metastasis but the others also had various degree of pulmonary metastasis and 2 of latter had hepatic metastasis, too. 8. Most of the cases were treated with CHAMOCA regimen, and one of them was taken whole brain irradiation (3000 rads/2 weeks). Another on case revealed marked regression of not only metastatic brain lesion but the pulmonary lesion after the 8th course of CHAMOCA regimen and still alive for over 460 days.

  19. A case of lung adenocarcinoma with multiple intracranial hemorrhages of brain metastases after whole-brain radiation therapy

    International Nuclear Information System (INIS)

    Whole-brain radiation therapy (WBRT) is widely applied in cases of brain metastases of non-small cell lung cancer (NSCLC). However, there are few case reports on hemorrhages of brain metastases occurring after WBRT. A 63-year-old woman was given a diagnosis of stage IV (T4N0M1b) lung adenocarcinoma about 4 years previously, and received chemotherapy regimens and gamma knife radiosurgery. However, her brain metastases exacerbated and she received WBRT in November 2010 and docetaxel monotherapy in December 2010. Two weeks after completing WBRT, she experienced dysarthria and an MRI showed multiple hemorrhages within brain metastases. Over a period of careful observation, these hemorrhages repeatedly alternated between improvement and exacerbation. Radiotherapy for metastatic brain tumors is considered to suppress hemorrhagic events of brain metastases. However, multiple intracranial hemorrhages of brain metastases occurred after WBRT in the present case. The accumulation of further studies of similar cases is necessary to identify the exact mechanism of these hemorrhages. (author)

  20. The diagnostic contribution of computed tomography in intranasal carcinoma with retrobulbar, oral and brain invasion in a canine: case report

    International Nuclear Information System (INIS)

    Intranasal tumors are uncommon and in most cases are malignant, aggressive and with low to moderate potential for metastasis. Clinical signs are usually caused by progressive obstruction of the upper airways. The test cytopathological also is a diagnosis method, but the definitive diagnosis is made by histopathological. Computed tomography (CT) is recommended to treatment planning. A poodle was attended at the veterinary hospital with a clinical history of epistaxis and nasal and ocular secretions, seizures and severe dyspnoea. The animal underwent to radiographic examination of the chest and skull as well as helical computed tomography of the nasal cavity and brain before and after the administration of intravenous contrast. The CT findings revealed an expansive bilateral nasal cavity neoformation, with involvement of the retrobulbar space, right frontal sinus, brain and oral cavity, suggesting a neoplastic or an infectious process. The CT examination allowed the material collection, directly from the mass, to cytological examination, providing the diagnosis of carcinoma. CT also allowed the determination of the unfavorable prognosis of the patient and the treatment planning which not included the surgical excision of the neoformation. Although CT was not conclusive in the diagnosis of carcinoma, it was essential to accurately define the extent of the lesion, to guide the collection of material directly from the tumor and to determine the prognosis of the animal, proving to be an extremely useful tool in cases of tumors intranasal in dogs. (author)