Innumerable hemorrhagic brain metastases from a neuroendocrine tumor grade-1 with prolonged natural history
| Autor: | Mohammad Dababo, Turki Elarjani, Maher Hassounah, Othman Bin Alamer |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment NET neuroendocrine tumors Natural history Case Report Lung biopsy Neuroendocrine tumors 03 medical and health sciences 0302 clinical medicine Neuroendocrine tumor Biopsy medicine WBRT whole-brain radiation therapy medicine.diagnostic_test business.industry fungi Diffuse axonal injury GFAP glial fibrillary acidic protein food and beverages ECOG Eastern cooperative oncology group Brain metastases Low grade medicine.disease TTF-1 thyroid transcription factor-1 CT computed tomography Radiation therapy MANEC mixed adenoneuroendocrine carcinoma SWI susceptibility weighted imaging 030220 oncology & carcinogenesis Differential diagnosis 030211 gastroenterology & hepatology Surgery Radiology business MRI magnetic resonance imaging Brain metastasis Cerebral vasculitis |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| DOI: | 10.1016/j.ijscr.2021.105855 |
| Popis: | Highlights • Neuroendocrine tumor metastasis to the brain is a rare entity that commonly originates from the lungs. • Neuroendocrine tumor grade 1, which is considered benign, can metastasize to the brain. • Neuroendocrine tumor can mimic other cerebral metastatic diseases in terms of hemorrhagic appearance, and thus, should be considered among the differential diagnosis. Background Neuroendocrine tumors (NET) are rare tumors with a low incidence of brain metastasis, especially in grade 1 NET. The most common source of brain metastasis is the lung. We present an unusual case of NET grade 1 with multiple hemorrhagic brain metastases. Case description A 46-year-old woman, who initially presented with a seizure, was diagnosed with multiple brain and lung lesions. She was offered a biopsy for diagnosis, but she refused and lost to follow up. Eighteen years later, she developed progressive quadriparesis and confusion. A biopsy of the left frontal lobe lesions showed NET grade 1. A lung biopsy of the left upper lobe was consistent with the same diagnosis. The patient’s functional status was poor with Eastern Cooperative Oncology Group (ECOG) grade 4. She only received palliative whole-brain radiation therapy (WBRT) and died 3 months after discharge. Clinical discussion NET is a spectrum that encompasses benign to malignant cells. There is a female predominance in lower grades and male predominance in higher grades. No effective management for brain metastases was described, and the prognosis remains poor. Conclusion Multiple brain metastases can be the first presentation of patients with NET. Early diagnosis and treatment may have a more favorable impact on the outcome of this disease. The longstanding numerous hemorrhagic NET brain metastases is exceedingly rare. The neuroimaging appearance is similar to other neoplastic and non-neoplastic lesions. An important differential diagnosis to consider is metastatic melanoma and choriocarcinoma, familial cavernous malformation, diffuse axonal injury, cerebral vasculitis, and amyloid angiopathy. |
| Databáze: | OpenAIRE |
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