Abstract
The prognosis of patients diagnosed with stage IV nonsmall cell lung cancer that have brain and brainstem metastasis is very poor, with less than a third surviving a year past their initial date of diagnosis. We present the rare case of a 57-year-old man who is a long-term survivor of brainstem and recurrent brain metastasis, after aggressive treatment. He is now five and a half years out from diagnosis and continues to live a highly functional life without evidence of disease. Four separate Gamma Knife stereotactic radiosurgeries in conjunction with two craniotomies were utilized since his initial diagnosis to treat recurrent brain metastasis while chemoradiation therapy and thoracic surgery were used to treat his primary disease in the right upper lung. In his situation, Gamma Knife radiosurgery proved to be a valuable, safe, and effective tool for the treatment of multiply recurrent brain metastases within critical normal structures.
Highlights
Brainstem metastases are a difficult oncological and neurological clinical problem
We present the rare case of a 57-year-old man who is a long-term survivor of brainstem and recurrent brain metastasis, after aggressive treatment
Four separate Gamma Knife stereotactic radiosurgeries in conjunction with two craniotomies were utilized since his initial diagnosis to treat recurrent brain metastasis while chemoradiation therapy and thoracic surgery were used to treat his primary disease in the right upper lung
Summary
Brainstem metastases are a difficult oncological and neurological clinical problem. Whole-brain radiation therapy and stereotactic radiosurgery (SRS) are the most commonly used techniques for the treatment of brainstem metastasis. This paper presents the case of a man who underwent aggressive treatment for stage IV metastatic lung cancer with a subsequent pontine brainstem metastasis and other recurrent brain metastases. He underwent four separate stereotactic radiosurgeries with a Leskell Gamma Knife and two craniotomies for treatment of his brain lesions. He received chemotherapy, radiation therapy, and thoracic surgeries to treat the primary lung cancer. Case Reports in Oncological Medicine challenging situation, he is currently a long-term survivor and is five and a half years out from his stage IV diagnosis, with no current evidence of disease
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