Duodenal choriocarcinoma, either primary or metastatic, is very rare. Early diagnosis and prompt initiation of chemotherapy improve the prognosis of this neoplasm. We herein present, together with the referred literatures, a case of a 47-year-old female patient who visited to our hospital with upper intestinal bleeding. She was diagnosed as duodenal choriocarcinoma by operation. Brain metastasis was found soon after the operation and combination chemotherapy was done.
Brain Neoplasms/*secondary ; Choriocarcinoma/*diagnosis/secondary ; Duodenal Neoplasms/*diagnosis/pathology ; Female ; Gastrointestinal Hemorrhage/*diagnosis ; Humans ; Middle Aged

OBJECTIVETo report the MRI features of intracranial metastases of lung cancer.

METHODSA total of 858 patients with history of primary lung cancer suspicious of brain metastases was retrospectively reviewed with MRI.

RESULTS1. Of the 858 patients, 393 (45.8%) had brain metastases on MRI. The primary tumor was lung adenocarcinoma in 117 (29.8%), small cell lung cancer in 110 (28.0%), squamous cell cancer in 52 (13.2%), adenosquamous cancer in 16 (4.1%), large cell carcinoma in 2 (0.5%) and carcinoid in 1 (0.3%). The histopathological types of the primary tumor were unknown in 95 (24.2%). 2. Meningeal metastasis was found in 19 patients with lung cancer. The primary tumor was of adenocarcinoma lung in 6, small cell lung cancer in 5, squamous cell carcinoma in 4 and the remaining 4 were of unknown histopathological type. 3. Edema around the lesion: in 120 cases, there was no obvious edema; the edema was slight in 98 cases, moderate in 70, serious in 86.

CONCLUSIONThe brain metastasis of lung cancer is of common occurrence. MRI with enhancement is very helpful in the establishment of diagnosis.

Adenocarcinoma ; diagnosis ; secondary ; Adult ; Aged ; Brain Neoplasms ; diagnosis ; secondary ; Carcinoma, Small Cell ; diagnosis ; secondary ; Carcinoma, Squamous Cell ; diagnosis ; secondary ; Female ; Humans ; Lung Neoplasms ; pathology ; Magnetic Resonance Imaging ; methods ; Male ; Meningeal Neoplasms ; diagnosis ; secondary ; Middle Aged ; Retrospective Studies

Metastatic brain tumors from gastric cancer are extremely rare. A 61-year-old Korean woman, initially presenting with polydipsia and polyuria, was found to have metastatic lesions in the brain by MRI. We performed several diagnostic procedures to determine the origin of the brain metastases. She was revealed to have a soft tissue mass of the right adrenal gland and fungating ulcers in the stomach. Histologic studies of both the adrenal gland mass and gastric tissues revealed malignant tumors composed of anaplastic cells. Based on the electron microscopy study, the malignant tumor of the right adrenal gland was a metastatic lesion from the anaplastic carcinoma of stomach. Therefore, the malignant tumors of the brain were assumed to have originated from the gastric cancer. This case report is presented to make clinicians aware of the possibility that diabetes insipidus (polydipsia) may present as an initial manifestation of brain metastases.
Adrenal Gland Neoplasms/diagnosis/*secondary ; Brain Neoplasms/diagnosis/*secondary ; Carcinoma/*diagnosis ; Diabetes Insipidus/*etiology ; Female ; Humans ; Middle Aged ; Stomach Neoplasms/*diagnosis

OBJECTIVETo study the clinical characteristics and MR imaging features of intracranial metastasis from malignant tumors.

METHODS1271 patients who had history of primary tumor and suspected of cranial metastasis had MRI on Philips Gyroscan T5-NT MR scanner. The sequences included pre-contrast T(1)WI, FLAIR, and postcontrast transversal, sagittal, and coronal T(1)WI. All of the clinical data and MRI features of the patients were recorded and analyzed.

RESULTSOf 547 patients with intracranial metastasis, 393 came from lung cancer (71.9%), 10% of 547 patients were found to have the presenting symptoms of cranial metastasis. 526 had parenchymal cerebral metastasis, and 21 only meningeal metastasis. Of these 526 patients found to have brain metastasis, 164 had single metastasis (31.2%), and 362 multiple (68.8%). Most of the cerebral metastatic lesions showed uniform or ring enhancement after intravenous injection of contrast medium, dura-arachnoid metastasis showed continuous and thick-curve enhancement at the cerebral convex, but not extending to the sulcus, while pia-dura metastasis displayed as thin and linear or nodular enhancement extending to the adjacent sulci.

CONCLUSIONThe most common primary lesion with metastasis to the brain were lung cancers, followed by breast and gastrointestinal cancers. By using gadolinium-DTPA enhanced MR imaging, many single and small cerebral metastasis could be found earlier.

Adult ; Aged ; Brain Neoplasms ; diagnosis ; secondary ; Breast Neoplasms ; pathology ; Female ; Gastrointestinal Neoplasms ; pathology ; Humans ; Lung Neoplasms ; pathology ; Magnetic Resonance Imaging ; Male ; Meningeal Neoplasms ; diagnosis ; secondary ; Middle Aged

Adult ; Brain Neoplasms ; diagnosis ; secondary ; Female ; Humans ; Lymphomatoid Granulomatosis ; complications ; diagnosis ; Male ; Young Adult

OBJECTIVETo evaluate the value of (18)F-FDG and (11)C-MET PET-CT scan in differentiation of brain ringlike-enhanced lesions on MRI imaging.

METHODSForty-one brain ringlike-enhanced lesions on MRI imaging including 30 brain tumors and 11 non-neoplastic lesions confirmed pathologically or clinically underwent (18)F-FDG and (11)C-MET PET-CT brain scan. Among them, 15 patients who were suspected to have brain metastasis received body scan by (18)F-FDG PET-CT. Both images were analyzed visually and semi-quantitatively.

RESULTSVisual analysis: for brain tumors the diagnostic sensitivity, specificity and accuracy of (18)F-FDG PET-CT was 53.3%, 72.7%, 58.5%, versus 96.7%, 90.9%, 95.1% of (11)C-MET PET-CT, respectively. All the primary foci in 9 patients with brain metastases were detected by body (18)F-FDG PET-CT scan. Semiquantitative analysis: There was a significant difference in the uptake between highly differentiated malignant and poorly differentiated tumors as well as non-neoplastic lesions for both tracers (P < 0.01), while between low-grade malignant tumors and non-neoplasm lesions, there was a difference in uptake only by (11)C-MET (P < 0.01). No significant difference between the uptakes in brain metastasis and glioblastomas was found by both tracers (P > 0.05).

CONCLUSIONBoth (18)F-FDG and (11)C-MET PET-CT are useful in differentiation of brain ringlike-enhanced lesions on MRI imaging. (11)C-MET PET-CT is more helpful than (18)F-FDG PET-CT in differential diagnosis of low-grade neoplastic from non-neoplastic lesions. Combination of (18)F-FDG and (11)C-MET PET-CT scans can improve the accuracy of differential diagnosis for brain ringlike-enhanced lesions on MRI imaging.

Acetates ; Adolescent ; Adult ; Aged ; Brain Abscess ; diagnosis ; Brain Neoplasms ; diagnosis ; pathology ; secondary ; Carbon ; Carbon Radioisotopes ; Child ; Craniopharyngioma ; diagnosis ; pathology ; secondary ; Diagnosis, Differential ; Female ; Fluorodeoxyglucose F18 ; Glioblastoma ; diagnosis ; pathology ; secondary ; Humans ; Lung Neoplasms ; diagnosis ; pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pituitary Neoplasms ; diagnosis ; pathology ; secondary ; Positron-Emission Tomography ; methods ; Radiopharmaceuticals ; Sensitivity and Specificity ; Young Adult

OBJECTIVETo analyze the clinical characteristics and survival depending on biological subtypes in breast cancer patients with brain metastases (BM).

METHODSA retrospective analysis was performed on 152 breast cancer patients with BM admitted to the Cancer Institute & Hospital, Chinese Academy of Medical Sciences from January 2003 to December 2012. Depending on the biological characteristics, these patients were divided into three subtypes: Luminal, human epidermal growth factor receptor 2 (HER-2)-overexpressing, and triple-negative subtypes. The clinicopathological characteristics, recurrence status, and prognostic factors were analyzed at the initial diagnosis. The systemic therapy after BM was further studied.

RESULTSAmong the 152 patients, the number of Luminal, HER-2-overexpressing, and triple-negative breast cancer (TNBC) subtypes were 60, 53, and 39 cases, respectively. The median time from first recurrence to BM of all patients was 7.3 months, the median time of Luminal, HER-2-overexpressing, and TNBC subtypes was 11.0 months, 9.6 months, and 5.5 months, respectively (P < 0.001). Compared with the TNBC subtype, BM occurred later in the HER-2-overexpressing subtype (P < 0.001). In the HER-2-overexpressing subtype, trastuzumab could delay the occurrence of BM in advanced breast cancer patients (17.1 vs. 1.7 months, P < 0.001, 95%CI 5.21-13.98). The median time of overall survival (OS) in the whole group was 56.5 months (7.5-240.2 months, 95%CI 52.6-60.4). The median survival time of Luminal, HER-2-overexpressing and TNBC subtypes was 70.9 months, 53.9 months, and 40.9 months, respectively (P = 0.013). The median survival time of after BM was 11.5 months in the whole group, and the median survival time of Luminal, HER-2-overexpressing and TNBC subtypes was 11.2 months, 12.7 months, and 11.6 months, respectively, with a difference of no statistical significance. Compared with non-BM as the first site, the patients with BM as the first site had a longer survival (14.8 months vs. 8.0 months, P = 0.001). Systemic therapy could prolong the survival after BM. The median survival of chemotherapy, chemotherapy in combination with trastuzumab, and without systemic therapy was 13.6 months, 19.0 months, and 6.5 months, respectively (P = 0.043).

CONCLUSIONSThe survival after BM is influenced by biological subtypes. Compared with the Luminal subtype, brain meatastases occurr earlier in HER-2-overexpressing and TNBC subtypes. Trastuzumab can delay the occurrence of BM from advanced breast cancer, and systemic therapy can improve the survival of patients after brain metastasis.

Brain ; Brain Neoplasms ; diagnosis ; secondary ; Breast Neoplasms ; diagnosis ; pathology ; Female ; Humans ; Neoplasm Recurrence, Local ; diagnosis ; Prognosis ; Receptor, ErbB-2 ; Receptors, Estrogen ; Receptors, Progesterone ; Retrospective Studies

Aged ; Brain Neoplasms ; diagnosis ; pathology ; Central Nervous System Neoplasms ; diagnosis ; pathology ; Fatal Outcome ; Female ; Humans ; Lymphoma ; diagnosis ; pathology ; Meningeal Neoplasms ; diagnosis ; secondary

Fibromyalgia syndrome after comprehensive treatment of breast cancer is rare and seldom reported. Here we present a case of a 50-year-old female patient,who was admitted to the hospital because of generalized fibromyalgia for 3 months and brain metastasis after the right breast carcinoma surgery for 1 month, and the clinical diagnosis was brain metastasis from breast carcinoma combined with fibromyalgia syndrome. The fibromyalgia were relieved with proper symptomatic treatment but the patient eventually died of tumor progression.
Brain Neoplasms ; mortality ; secondary ; Breast Neoplasms ; complications ; mortality ; therapy ; Carcinoma ; mortality ; therapy ; Female ; Fibromyalgia ; diagnosis ; etiology ; therapy ; Humans ; Middle Aged

Metastasis of nasopharyngeal carcinoma (NPC) to the dura, an extremely rare condition, can be symptomatically silent and mistaken for a benign entity radiographically. Missed diagnosis can lead to serious consequences or prove immediately fatal. We report a woman with dural metastasis of NPC that mimicked a meningioma on radiography. Craniectomy with tumour resection was performed due to rapid progression from the onset of symptoms to disability. The patient was still alive two years after surgery. This case emphasises the need to keep in mind the possibility of dural metastasis of NPC in patients with abnormal imaging features. This would not only avoid wrong and optimistic diagnosis, but also allow for appropriate treatment in a timely manner. To our knowledge, this is the first report of metastasis of NPC to the dura. We provide detailed information on the neoplastic lesion, which masqueraded as a benign entity and caused potentially fatal consequences.
Adult ; Brain Neoplasms ; diagnosis ; secondary ; surgery ; Carcinoma ; Diagnosis, Differential ; Disease Progression ; Dura Mater ; pathology ; Female ; Humans ; Magnetic Resonance Imaging ; Meningioma ; diagnosis ; pathology ; Nasopharyngeal Neoplasms ; diagnosis ; pathology ; Neoplasm Metastasis