Cases Of Metastatic Brain Tumor Research Articles

Epidemiological Study of Metastatic Brain Tumors in Miyazaki Prefecture: A Regional 10-year Survey in Southern Japan.

Advances in cancer treatment have improved the survival of patients with cancer, with a concomitant increase in the proportion of patients with metastatic brain tumors (MBTs). In this study, we used cancer registries established in Japan after 2016 and available patient data by organ in order to conduct an accurate epidemiological study. To the best of our knowledge, this is the first study to report on the detailed epidemiological data on MBT at the prefectural level in Japan using the Miyazaki Brain Tumor Database and Miyazaki Cancer Registry. This study included 425 new cases of MBTs diagnosed in Miyazaki Prefecture from 2007 to 2016. As per our findings, the most frequent primary tumor in Miyazaki Prefecture was found to be in the lung (49.4%), followed by colon/rectum/anus (9.4%) and breast (8.5%). Among patients with MBTs, 59.1% were males, a number closely similar to that of Japan, as shown in the Japanese Brain Tumor Registry (55.5%). The median age at diagnosis was 68 and 63 years in Miyazaki Prefecture and Japan, respectively. Although more patients were symptomatic in Miyazaki Prefecture than in Japan (88.5% vs. 15.5%), fewer patients opted for surgery (33.6% vs. 61.9%), probably because of their advanced age at diagnosis. As per the findings of this study, the annual incidence rate of new MBTs (i.e., ratio of the number of new cancer registrations to that of new MBT patients in Miyazaki Prefecture) was at 0.41%. The number of tumor sites in MBTs was independent of the total number of cancers per organ. Considering the expansion of cancer registries worldwide, including those on brain tumors, further epidemiological analysis of MBTs is deemed warranted.

COT-12 ANALYSIS OF 5-ALA STRONGLY POSITIVE FINDINGS USING IMAGE J FOR MALIGNANT BRAIN TUMOR

Abstract For brain tumor surgery using 5-ALA during surgery, we analyze the brightness using image analysis software Image J, we report the results to date for strongly positive findings. Thirty-nine patients who were suspected of having malignant glioma before surgery and who were strongly positive for 5-ALA during surgery were included. (21 malignant glioma, 14 metastatic brain tumor, 3 meningioma, and 1 germ cell tumor.) Intraoperative 5-ALA-positive findings were analyzed with image analysis software Image J (Wayne Rasband: NIH), brightness was measured with histograms, and maximum brightness was compared. The average maximum brightness titer was 106.38 (50-225) in 21 cases of malignant glioma. The brightness titer was 84.5 (28-121) in 14 cases of metastatic brain tumor, 80 (59-97) in meningioma, and 43 in 1 case of germ cell tumor. No clear correlation was found between brightness, tumor grading, and MIB-1 LI. In addition, a clear difference in luminance was observed between the tumor and the ventricle in one case.By analyzing brightness with Image J, it will be possible to obtain informations about tumors from different perspectives.

Brain Metastases in Adults: A Five-Year Observational Study From King Abdulaziz Medical City.

Background As a well-documented fact, metastatic brain tumors are the most common cause of brain tumors in adults, with an incidence of 9-17%, based on various studies, although it was thought to be higher. The aim of this study was to describe recorded cases of metastatic brain tumors in the adult population of a tertiary care and oncology center in Jeddah, Saudi Arabia. Methods This study was conducted at King Abdulaziz Medical City (KAMC) at King Khalid Hospital in Jeddah, Saudi Arabia, including records from January 2016 to December 2020. The study implemented a retrospective cohort design to fulfill its aim. A data collection sheet containing demographic data such as age and gender, and information pertaining to the primary pathology, multiplicity, and survival outcome was used. Results A total number of 213 patients were enrolled in this study. Overall, 68.1% of the sample comprised of females. Approximately two-thirds (61.9%) of the patients' imaging results revealed multiplicity, whereas the remaining third (38.1%) had solitary lesions. The estimated overall survival median after the diagnosis of brain metastasis was six months (95% CI: 5.5-6.5). Conclusion We recommend conducting a nationwide study to better understand the incidence in accordance to geographical and gender differences. We can further expand our research to include other institutes in Saudi Arabia, and include important predictors such as time from the diagnosis of primary pathology to brain metastasis, disease progression cost, and disease progression in the months prior to the patients' death.

Pheochromocytoma with Brain Metastasis: A Extremely Rare Case in Worldwide

Pheochromocytoma (PCC) is a neuroendocrine tumor that mainly arises from the medulla of the adrenal gland. Some PCCs become malignant and metastasize to other organs. For example, it typically involves skeletal system, liver, lung, and regional lymph nodes. However, only a few cases of PCC with brain metastasis have been reported worldwide. We report a case of metastatic brain tumor from PCC in South Korea in 2016. A 52-year-old man presented with headache, dizziness and motor aphasia. He had a medical history of PCC with multi-organ metastasis, previously underwent several operations, and was treated with chemotherapy and radiotherapy. Brain MRIs showed a brain tumor on the left parietal lobe. Postoperative pathology confirmed that the metastatic brain tumor derived from malignant PCC. This is the first report PCC with brain metastasis in South Korea.

A Case of Metastatic Brain Tumor Complicated by Multiple Repeated Hemorrhages

Metastatic brain tumor occasionally results in multiple cerebral hemorrhages. Here, we report a case of metastatic brain tumor complicated by multiple repeated cerebral hemorrhages. An 80-year-old man with a history of removal of lung cancer was admitted to our hospital because of disturbed consciousness following headache. A brain CT revealed a mass lesion of 40-mm diameter in the left cerebellum and a mass lesion of 2-mm diameter in the right temporal lobe. The cerebellar mass lesion showed homogeneous iso-density, indicating a subacute phase hemorrhage. Two days later, a follow-up CT revealed that the mass lesion had become high-density, indicating complication by a fresh hemorrhage. Hematoma was removed and histological examination was performed on the cerebellar lesion. There was leakage of dark-red liquid intraoperatively, and histological examination revealed an adenocarcinoma, indicating metastasis of the lung cancer. Additionally, necrosis and hemorrhage were identified. Postoperatively, whole brain irradiation was performed. The right temporal lesion gradually enlarged but disappeared after irradiation. In conclusion, multiple brain metastases may result in multiple cerebral hemorrhages. Repeated hemorrhage from necrosis of the carcinoma causes a slowly growing hematoma.

A case of metastatic brain tumor with the incipient symptoms of paralysis of the hypoglossal nerve

A case of metastatic brain tumor with the incipient symptoms of paralysis of the hypoglossal nerve

A case of metastatic brain tumor in the perfusion territory of superficial temporal artery-middle cerebral artery anastomosis.

Background:We report a rare case of metastatic tumor in the perfusion territory of superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis.Case Description:A 63-year-old man, who had undergone left STA-MCA anastomosis in the treatment of occlusion of internal carotid artery 4 years ago, presented with a hyperintense lesion on T2-weighted image in the left frontal lobe, the perfusion territory of the prior bypass. Follow-up magnetic resonance imaging 1 month later showed enhanced tumor within the T2 hyperintense lesion. A total removal of the tumor through another craniotomy was performed. The pathologic diagnosis was metastatic carcinoma.Conclusion:This is the first report of the metastatic carcinoma by seeding of tumor cells through STA-MCA bypass flow.

Hemorrhagic Brain Metastasis of Endometrial Stromal Sarcoma

High-grade endometrial stromal sarcoma is a rare uterine malignancy. The cells of these tumors resemble endometrial cells in the proliferation stage, with many small plexiform arterioles. Herein we present a patient with endometrial stromal sarcoma that metastasized to the brain, along with the CT and MRI findings and a discussion of the surgical and histopathological features of the metastatic tumor. Immunohistopathological examination of the metastatic tumor showed a high mitotic rate and strong immunopositivity for CD10 and vimentin (as a mesenchymal marker); therefore, the lesion was considered to be high-grade endometrial stromal sarcoma. Due to the rarity of reported cases of metastatic brain tumors of high-grade endometrial stromal sarcoma, there isn’t a standard treatment protocol; however, metastatic tumors of high-grade endometrial stromal sarcoma match the same general concepts of brain metastasis. In addition, endometrial stromal sarcomas may be associated with hemorrhagic metastasis to the brain due to their pathologic characteristics.

Hemorrhagic Brain Metastasis of Endometrial Stromal Sarcoma

High-grade endometrial stromal sarcoma is a rare uterine malignancy. The cells of these tumors resemble endometrial cells in the proliferation stage, with many small plexiform arterioles. Herein we present a patient with endometrial stromal sarcoma that metastasized to the brain, along with the CT and MRI findings and a discussion of the surgical and histopathological features of the metastatic tumor. Immunohistopathological examination of the metastatic tumor showed a high mitotic rate and strong immunopositivity for CD10 and vimentin (as a mesenchymal marker); therefore, the lesion was considered to be high-grade endometrial stromal sarcoma. Due to the rarity of reported cases of metastatic brain tumors of high-grade endometrial stromal sarcoma, there isn't a standard treatment protocol; however, metastatic tumors of high-grade endometrial stromal sarcoma match the same general concepts of brain metastasis. In addition, endometrial stromal sarcomas may be associated with hemorrhagic metastasis to the brain due to their pathologic characteristics.

Intraoperative rapid diagnosis of primary central nervous system lymphomas: advantages and pitfalls.

To study the advantages and pitfalls of intraoperative rapid diagnosis (IRD) of primary central nervous system lymphomas (PCNSL), pathology reports and frozen sections in our institution were reviewed. We examined 27 cases of PCNSL, one case of anaplastic glioma, and one case of metastatic brain tumor that were diagnosed on neuroimaging. Fifteen cases of intraoperative cytological preparations were also reviewed in a correlative manner. Among the 27 cases initially diagnosed as PCNSL, 18 were also diagnosed as PCNSL by IRD. However, IRD identified four of the 27 cases as gliosis, two as demyelination, one as atypical epithelial cells, one as malignant glioma and anaplastic astrocytoma. In addition, the case identified as metastatic brain tumor on neuroimaging was corrected to a diagnosis of PCNSL based on IRD. The final accuracy of IRD in the present study was 89.6% (26/29). After postoperative definitive diagnosis, two cases of anaplastic astrocytoma and one case of PCNSL by IRD were corrected to PCNSL, anaplastic oligodendroglioma and demyelination, respectively. PCNSL were sometimes histologically indistinguishable from malignant gliomas or demyelinating diseases in the present study, particularly in frozen sections. Notably, all cases for which both intraoperative cytology and frozen section were performed concomitantly were correctly diagnosed in the present study. In particular, lymphoglandular bodies were highly characteristic cytological findings of PCNSL. Both intraoperative cytology and frozen sections should therefore be performed concomitantly when PCNSL are suspected.

A Unique Case of Metastatic Brain Tumor at the Insular Cortex

A Unique Case of Metastatic Brain Tumor at the Insular Cortex

What is the Value of Whole Brain Radiotherapy in the Worst Prognosis Subgroup of Patients with Brain Metastases?

More than 170,000 cases of metastatic brain tumors are diagnosed in the United States each year. The Radiation Therapy Oncology Group (RTOG) Recursive Partition Analysis (RPA) and the Graded Prognostic Assessment (GPA) are the two main validated prognostic indices used to estimate the length of survival for these patients and to help guide clinicians' treatment decisions. Poor prognosis patients (RPA III or GPA 0.0 - 1.0) are commonly treated with steroids plus whole brain radiation (WBRT), though the benefit of WBRT for these patients is poorly documented.

Brain metastases from apocrine carcinoma of the scalp: case report

Apocrine carcinoma is an extremely rare malignant neoplasm that occurs most frequently in the axilla. Although it usually shows an indolent clinical course, it often metastasizes to regional lymph nodes and sometimes to lungs or bones. However, a literature search did not reveal any report describing the detailed clinical course of brain metastases from apocrine carcinoma. We report a case of a 54-year-old male who suffered from multiple brain metastases from apocrine carcinoma that had originated in the scalp 6 years before. The brain metastases appeared in spite of several regimens of chemotherapy for lung metastases for two years. The tumor in the right frontal lobe was successfully operated. However, the small tumor in the right occipital lobe was not cured by gamma knife surgery, and eventually required second operation. The operation had contributed to his neurologically independent life for about one year until he died for gradual progression of lung metastases. To our knowledge this is the first reported case of metastatic brain tumor from apocrine carcinoma.

Prognostic factors in patients who survived more than 10 years after undergoing surgery for metastatic brain tumors: Report of 5 cases and review of the literature

BACKGROUND Although the overall prognosis of patients with metastatic brain tumors is dismal, a small number survive longer than 10 years after craniotomy. We report 5 patients who survived for more than 10 years after undergoing treatment for metastatic brain tumor. METHODS The 5 patients who survived for more than 10 years after undergoing craniotomy were among 56 consecutively treated patients with solitary metastatic brain tumors. We retrospectively examined their clinical course, treatment, and variables associated with their longer survival and compared these 5 patients with other reported cases of metastatic brain tumor. RESULTS The histologic tumor types and the sites of origin of the primary tumor varied: two were from lung cancer and one each was from colon cancer, renal cell, and cervical carcinoma of the uterus. Common features among the long-term survivors were: systemic disease was absent, the metastatic tumor was located in the non-eloquent area of the non-dominant hemisphere, they were in good neurologic condition before surgery, there was a long interval between the diagnosis and treatment of the primary lesion and the diagnosis of the brain metastasis, and the patients received postoperative irradiation/chemotherapy. CONCLUSION Aggressive surgical treatment may be justified in young patients with a solitary metastatic brain tumor, as long as they are free of active systemic metastases.

脳重瘍に対するPDTの特性とその応用

We have applied Stereotactic Intratumoral Photodynamic Therapy using HPE and argon-dye laser for 20 malignant brain tumors of 16 cases. The 6 females and 9 males were from age of 22 to 77. The average age was 52.5 years old. There were 7 cases of glioblastoma (3 recurrence), 4 cases of astrocytoma grade III, 4 cases of metastatic brain tumors and 1 case of PNET. All tumors clearly showed a reduction in tumor volume 4 weeks after stereotactic PDT. In the case of 20.7cc or lower volume (85%,17 tumors), therapeutic effects was obtained for all of them. The largest tumor which showed complete disappearance on enhanced CT or MRI had a volume of 4.6cc.The data indicate that it is possible to consider stereotactic intratumoral PDT showing adequate therapeutic effects as an adjuvant therapy for malignant brain tumors.

FIVE CASES OF METASTATIC BRAIN TUMOR WITH SURGICAL TREATMENT OF BOTH METASTATIC AND PRIMARY LESIONS

We report five cases of metastatic brain tumor preceded by neurological symptoms. All patients received removal of the brain tumors prior to resection of the primary lesions. The primary site of cancer was the lung in 3 patients, and esophagus and breast in one each. The number of brain tumor was one in four patients and 3 in one. The duration from the removal of the brain tumors to the resection of the primary lesions ranged from 0.5 to 6 months. Two patients with lung cancer, who did not undergo postoperative whole brain radiation therapy, died of recurrence of brain tumors 14 months and 15 months after the resection of the primary lesions, respectively. On the other hand, no recurrence of the brain tumor was found in 3 patients with postoperative whole brain radiation. One patient with breast cancer died 14 months, and two patients with esophageal and lung cancer are alive 30 months and 37 months after the resection of the primary lesions, respectively. Curative resection for both brain metastasis and primary lesions was performed in 2 patients surviving for more than two years. Resection of brain metastasis and primary lesions, and postoperative whole brain radiation therapy according to the progressive extent of the lesions would improve the prognosis.

The effect of Antineoplaston, a new antitumor agent on malignant brain tumors.

Antineoplaston (Ap), a new antitumor agent, was clinically tested for effects on malignant brain tumors. The materials were 3 cases of glioblastoma (G,B), 2 cases of anaplastic astrocytoma, 1 case of pontine glioma, 2 cases of metastatic brain tumor and 1 case of medulloblastoma. All patients underwent radiochemotherapy and surgical resection of the tumors except the cases of pontine glioma, metastatic brain tumor and anaplastic astrocytoma. For gliomas, radiochemotherapy was used with Hu-IFN-beta. Ap was administered at a dose of 7-10 g/day in combination with remission maintenance therapy of gliomas. Complete response was obtained in one anaplastic astrocytoma. Partial response was obtained in 2 cases, a pontine glioma and a metastatic brain tumor. No change was observed in 2 cases, an anaplastic astrocytoma and a multiple brain metastasis. Progression of the disease was observed in 4 cases, 3 glioblastomas and 1 medulloblastoma, which showed continuous increase in tumor size. The effects of Ap on malignant brain tumors were considered due to synergy, since it was administered with other drugs and acceleration of tumor cellular differentiation. Ap is useful as an approach to remission maintenance therapy for brain tumors.

著明な神経浸潤をきたした大腸癌脳転移の２切除例

大腸癌の血行性転移は肝,肺が多く脳転移は比較的稀である.症例1は74歳,男性.S状結腸癌で前方切除術を施行した,術後1年後に脳転移が発見された.同時期肝転移を認あたが,神経症状が高度で脳転移巣の摘出術を施行した.症例2は60歳,女性.局所に浸潤した直腸癌で低位前方切除左腎,子宮両側付属器切除術を施行した.術後2カ月後肝・肺転移は認めなかったが・第3脳室に転移が発見され外科的療法を施行した.2例とも,原発巣において著明な神経浸潤がみられ,神経接着分子であるNCAM発現がみられたことより血行性転移先での臓器親和性の関与が示唆される症例と思われる.神経浸潤が著明な症例には脳転移にも注意が必要と思われた.

SURGICAL RESULTS OF BRAIN METASTASIS FROM LUNG CANCER

Thirty-two cases of metastatic brain tumor from lung cancer were retrospectively analyzed. Median survival time after the treatment of metastatic brain tumor was 29 weeks (7 months), with the longest survival being 10 years. Factors such as surgical removal of the metastatic brain tumor, radiation therapy for the brain, and Karnofsky performance status of more than 80 were shown to be associated with significantly improved survival. Meningeal carcinomatosis was associated with poorer survival. Gender, age, single or multiple metastasis, histological type and chemotherapy were not associated with prognosis. Nine autopsy cases showed that the cause of death was mainly brain metastasis in two cases, and mainly progression of lung cancer with cachexia in 7 cases. For better treatment, cooperation among oncologists, radiologists, radiation oncologists, surgeons, neurosurgeons and psychiatrists must be improved.

Ganglioside composition and its relation to clinical data in brain tumors.

The ganglioside composition of 15 cases of meningioma, 15 cases of astrocytoma, 5 cases of neurinoma, 4 cases of ependymoma, 3 cases of metastatic brain tumor and 1 case each of mixed glioma, oligodendroglioma, medulloblastoma, embryonal carcinoma, and cultured glioma cell line were analyzed by thin-layer chromatography. The GM2, GD3, and GD2 content of the tumors was determined using specific monoclonal antibodies (MAb). Cases were grouped according to the difference in ganglioside pattern and various clinical features. In meningiomas and astrocytomas, GM3 and GD3 were the major gangliosides. The tumor content of the rather simple gangliosides (GM3, GM2, GD3, GD2) increased or was almost equal to that of normal tissue (leptomeninges tissue in the case of meningiomas, and brain tissue in the case of astrocytomas), while the tumor content of complex gangliosides (GM1, GD1a, GT1a, GT1b) decreased as compared with normal tissue. The GM3 content of meningiomas increased in middle-aged patients, who comprised the majority of the patients with these tumors. The GD2 content decreased in middle-aged patients with initial symptoms of meningioma within a year. The GM3 content of astrocytomas decreased in patients who underwent radiotherapy. The amount of GM3 and GD3 increased in small tumors. GM3 may be related to the early proliferative stage. The ganglioside patterns of brain tumors are shown in this study to differ according to clinical features and also to be changeable in their clinical courses.