1/125. Hemorrhagic cerebellar metastasis from papillary thyroid carcinoma.Papillary thyroid carcinoma has a low incidence of distant metastases. Brain metastasis is extremely rare with a frequency of 0.1-1.3%. In the present series, the rate was 1.5%, only two cases had cerebral metastases in 136 patients with papillary thyroid carcinoma from January 1988 to April 1998. Cerebellar metastasis is even rarer, and solitary cerebellar metastasis has not been reported to the best of our knowledge. Two cases of papillary thyroid carcinoma with cerebellar metastases presenting as tumor hemorrhage are reported. In one patient, the lesion was in the bilateral cerebellar hemispheres with obstructive hydrocephalus. After operation, the patient had an uneventful course with recovery of her consciousness. In the other, the solitary lesion was in the left cerebellar hemisphere without obstructive hydrocephalus. After surgical treatment, the patient had a smooth course with resolution of his neurological deficit. It shows the importance of surgery in the management of a hemorrhagic cerebellar metastasis from papillary thyroid carcinoma, not only in reducing acute aggravating cerebral symptoms, but also in prolonging survival time.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
2/125. HPV in situ hybridization with catalyzed signal amplification and polymerase chain reaction in establishing cerebellar metastasis of a cervical carcinoma.We report an unusual case of cerebellar metastasis from a cervical adenosquamous carcinoma in which molecular techniques assisted in establishing the correct diagnosis. The patient was a 43-year-old woman with surgically unresectable cervical carcinoma diagnosed 2 years before presenting with neurological symptoms. A magnetic resonance imaging scan showed a large, enhancing cerebellar lesion with significant brain stem compression. The excised cerebellar tumor resembled a small cell carcinoma and was initially not thought to be a metastasis from the cervical adenosquamous carcinoma. in situ hybridization with catalyzed signal amplification and polymerase chain reactions with primers specific for human papilloma virus (HPV) types 16 and 18 were used to determine the relationship between the cervical and the cerebellar neoplasms. A positive signal was present in the nuclei of both neoplasms by in situ hybridization using HPV16/18 dna probes. polymerase chain reaction revealed the presence of HPV-18 DNA sequences in the cervical and cerebellar neoplasms confirming that the cerebellar neoplasm was a metastasis from the cervical primary.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
3/125. Brain metastasis of Merkel cell carcinoma. Case report and review of the literature.Merkel cell carcinoma (MCC) is a rare primary cutaneous neuroendocrine tumor that is locally aggressive and has potential for metastatic spread. However, brain metastases are rare, and therapy for such tumors has never reported. The authors present a 48-year-old woman with MCC of the left elbow and a right cerebellar metastasis. After the right cerebellar mass was totally resected, radiation treatment and chemotherapy were performed. Eight cases of brain metastasis have been reported in the literature, but only 5 have been presented in sufficient detail for analysis. Therapy for brain metastases has always been palliative whole-brain irradiation and chemotherapy except for our patient, who underwent total removal of the tumor and survived for 11 months without neurological deficit. Except in the case of 1 with a particularly radiosensitive MCC, the patients with brain metastases died within 9 months after detection of the brain lesions. If possible, aggressive excision of brain metastases as well as of the primary lesion should be done.- - - - - - - - - - ranking = 0.625keywords = carcinoma (Clic here for more details about this article) |
4/125. Bilateral cerebellopontine metastases in a patient with an unknown primary.We report the case history of a patient who presented with symptoms and signs suggestive of a left cerebellopontine tumour. He underwent an exploratory posterior fossa craniotomy, which revealed metastatic adenocarcinoma. Despite intensive investigation, a primary site was not located and the patient received cranial irradiation. The patient re-presented 2 years later with further symptoms from a metastasis in the right cerebellopontine angle. He refused further intervention.- - - - - - - - - - ranking = 0.14192304865668keywords = carcinoma, adenocarcinoma (Clic here for more details about this article) |
5/125. Ovarian carcinoma relapsing as a cerebellopontine angle tumour.Involvement of the central nervous system in epithelial ovarian carcinoma is rare. A 46-year-old woman with ovarian carcinoma relapsing with brain metastasis is described. She received radiotherapy for the metastasis and survived for 18 months.- - - - - - - - - - ranking = 0.75keywords = carcinoma (Clic here for more details about this article) |
6/125. Subclinical thyroid disease after radiation therapy detected by radionuclide scanning.PURPOSE: The actuarial risk for developing benign or malignant thyroid disease following radiation therapy (RT) is controversial, but may be as high as 50% at 20 years. An effective screening modality should be specific but not overly sensitive, a limitation of ultrasound. We questioned whether technetium-99 m pertechnetate ((99m)Tc TcO(4)(-)) scanning could detect clinically significant disease in ostensibly disease-free cancer survivors. methods AND MATERIALS: Eligibility criteria included an interval of at least 5 years after RT to the cervical region, a thyroid gland that was normal to palpation, euthyroid status determined by clinical examination, free T4 and TSH. The 34 patients scanned included 16 children (<18 years old) and 18 adults at the time of RT, 16 females and 18 males. The mean age at RT was 20 years (range, 2.1-50.3 years), and the mean age at (99m)Tc TcO(4)-scanning was 33 years (range, 13.6-58 years), providing a mean interval of 13 years (range, 5.3-26.6 years). The mean RT dose to the thyroid was 36.4 Gy (range, 19.5-52.5). Thyroid scanning was performed with a 5 mCi dose of (99m)Tc TcO(4)(-) obtaining flow, immediate and delayed static, and pinhole collimator images. RESULTS: Seven patients (21.6%) had abnormal scans, and the percentage was higher among children (25%) and females (25%) compared to adults (16.7%) and males (16.7%), respectively. Two of 34 patients (5.9%) were discovered to have a thyroid cancer; histopathologies were papillary and follicular carcinoma. CONCLUSION: In this population of clinically normal cancer survivors who had been irradiated to the cervical region, subclinical thyroid disease, of potential clinical significance, was detected by (99m)Tc TcO(4)(-) in about 20%. Children may be more commonly affected. Although the cost effectiveness of screening will require a larger sample number, we propose a surveillance schema for this patient population.- - - - - - - - - - ranking = 0.125keywords = carcinoma (Clic here for more details about this article) |
7/125. cerebellopontine angle involvement by nasopharyngeal carcinoma.OBJECTIVE: This article describes a series of patients with nasopharyngeal carcinoma involvement of the cerebellopontine angle and discusses the clinical significance of this entity. SETTING: Tertiary referral center. STUDY DESIGN: Retrospective case study. patients: patients who were diagnosed with nasopharyngeal carcinoma with clinical features of cerebellopontine involvement by tumor. INTERVENTIONS: Cerebellopontine involvement by tumor confirmed by computed tomography, magnetic resonance imaging, or both. RESULTS: patients with this entity either had advanced disease or had been treated previously for advanced nasopharyngeal carcinoma. They had varied clinical features attributable to cerebellopontine involvement, such as sensorineural deafness, dizziness, facial palsy, and facial numbness. CONCLUSIONS: cerebellopontine angle involvement by nasopharyngeal carcinoma is a difficult entity, both from the diagnostic and therapeutic points of view. In high-risk patients, particularly in patients who were previously treated for advanced nasopharyngeal carcinoma, a high index of suspicion for nasopharyngeal carcinoma involvement of the cerebellopontine angle is warranted when they experience unexplained neurootologic symptoms such as sensorineural hearing loss, dizziness and facial palsy.- - - - - - - - - - ranking = 1.25keywords = carcinoma (Clic here for more details about this article) |
8/125. Metastatic thymic carcinoma in a digit: a case report.Acrometastases are a rare but important clinical entity. We present the case of a 54-year-old man with a metastasis to a digit from a primary thymic carcinoma. The prognostic implications of such a diagnosis are discussed.- - - - - - - - - - ranking = 0.625keywords = carcinoma (Clic here for more details about this article) |
9/125. cerebellopontine angle metastasis from papillary carcinoma of the thyroid: case report and literature review.BACKGROUND: Papillary thyroid carcinoma is the most common type of well-differentiated thyroid malignancy and typically has an excellent prognosis and a low incidence of distant metastasis. However, once metastasis has developed in a distant site, prognosis is markedly diminished. Brain metastases from papillary thyroid carcinoma are extremely rare. Currently, there are no established therapeutic guidelines for treating brain metastases from thyroid carcinoma. CASE DESCRIPTION: We report on the case of a patient who presented with worsening neurological symptoms 3 years after resection of a thyroid papillary carcinoma. magnetic resonance imaging identified a lesion of the cerebellopontine angle that encased the lower cranial nerves. The patient underwent a left retrosigmoid craniotomy with a 98% resection of the mass and received postoperative adjuvant radioiodine therapy, external beam radiation, and Gamma Knife radiosurgery. The patient tolerated the procedure well and demonstrated significant progressive improvement in her neurological symptoms postoperatively. After the multimodal approach to therapy, she remains symptom-free at 3-year follow-up. Radiographic monitoring of the small tumor remnant reveals a decrease in size from the postoperative period. CONCLUSION: This article is the first formal case report of cerebellopontine angle metastasis from papillary thyroid carcinoma. Therapeutic protocols for brain metastases of papillary thyroid carcinoma are not firmly established. This case illustrates the unique event of a cerebellopontine angle metastasis from papillary thyroid carcinoma, which was successfully treated with a combination of surgical, chemical, and radiological modalities. This aggressive course of therapy has resulted in an excellent outcome in this instance.- - - - - - - - - - ranking = 1.375keywords = carcinoma (Clic here for more details about this article) |
10/125. Radiation-induced cavernous angioma mimicking metastatic disease.patients with carcinoma of the lung typically have a limited life expectancy especially after developing metastatic disease in the brain. New enhancing lesions in the brain are usually felt to represent new areas of metastasis. Recently, there have been several case reports of cavernous angiomas appearing years after radiation to the brain, typically in children. We present a case of a 41-year-old gentleman with carcinoma of the lung with metastasis to the brain who received postoperative radiation. Five-and-a-half years later he presented with a new enhancing lesion of the brain with surrounding vasogenic oedema, thought to represent a metastatic tumour. It proved is the a radiation-induced cavernous angioma.- - - - - - - - - - ranking = 0.25keywords = carcinoma (Clic here for more details about this article) |
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